Implementing technology to support the deteriorating patient in acute care: evaluating staff views

2021 ◽  
Vol 30 (16) ◽  
pp. 950-955
Author(s):  
Ashleigh Irons ◽  
Joanne McPeake ◽  
John Stuart ◽  
Shona MacNeilage ◽  
Ann-Frances Fisher ◽  
...  
Keyword(s):  
Improve Patient Safety ◽  
New Technology ◽  
Hospital Setting ◽  
Absolute Number ◽  
Service Evaluation ◽  
Structured Interviews ◽  
Support Worker ◽  
Handheld Device ◽  
Deteriorating Patient ◽  
The Individual

Background: Early warning scores (EWS) have been widely used to aid in the detection of deterioration. The use of technology, alongside EWS, may improve patient safety and lead to improvements in the accuracy of documentation. Aim: The aim of this service evaluation was to understand nurses' and healthcare support worker views around the implementation of handheld electronic devices for documenting care related to the deteriorating patient. Methods: Before the implementation of an electronic handheld device, in-depth semi-structured interviews with nursing staff and healthcare support workers were undertaken to explore the context for improvement. The Consolidated Framework for Implementation Research was used to analyse, organise and present data, to ensure systematic inquiry across the range of potential facilitators and challenges perceived by staff. In all, 11 interviews were undertaken across three speciality areas (four wards). Findings: Challenges to the use of new technology included staff apprehension around training and education needs and the uncertainty of technological reliability in the clinical setting. Potential facilitators to support the implementation of this technology were: the potential for improved communication across the individual ward and hospital setting and the potential for more streamlined processes for escalation of concerns. Conclusion: Three main recommendations for practice emerged. First, nurses should be involved in the development of the systems. Appropriate time is required to embed the technology in practice. Finally, thought must be given not just to the absolute number of devices required and their reliability, but also how new technology interacts in each individual context.

scholarly journals COVID-19 and Psychosocial Support Services: Experiences of People Living with Enduring Mental Health Conditions

2021 ◽  
Author(s):  
Anne Honey ◽  
Shifra Waks ◽  
Monique Hines ◽  
Helen Glover ◽  
Nicola Hancock ◽  
...  
Keyword(s):  
Mental Health ◽  
Support Services ◽  
Psychosocial Support ◽  
Secondary Analysis ◽  
Service Evaluation ◽  
Health Conditions ◽  
Structured Interviews ◽  
Support Worker ◽  
Living Situation ◽  
Mental Health Conditions

AbstractThis paper uses secondary analysis to understand how COVID-19 shaped people’s experiences with psychosocial support services in Australia. Data are drawn from questionnaires (n = 66) and semi-structured interviews (n = 62), conducted for a national service evaluation, with 121 people living with enduring mental health conditions and using psychosocial support services. Data relating to COVID-19 were inductively coded and analysed using constant comparative analysis. Most people’s experiences included tele-support. While some people described minimal disruption to their support, many reported reduced engagement. People’s wellbeing and engagement were influenced by: their location, living situation and pre-COVID lifestyles; physical health conditions; access to, comfort with, and support worker facilitation of technology; pre-COVID relationships with support workers; and communication from the organisation. The findings can help services prepare for future pandemics, adjust their services for a ‘COVID-normal’ world, and consider how learnings from COVID-19 could be incorporated into a flexible suite of service delivery options.

scholarly journals P033 Improving paediatric practice through multidisciplinary safety huddles

2019 ◽  
Vol 104 (7) ◽  
pp. e2.38-e2
Author(s):  
Ka Yu Yung ◽  
Ruchi Sinha ◽  
Susan Giles
Keyword(s):  
Patient Safety ◽  
Improve Patient Safety ◽  
Hospital Setting ◽  
Error Rates ◽  
Lessons Learned ◽  
List Type ◽  
Department Of Health ◽  
Health And Social Care ◽  
The Individual ◽  
Learned Safety

BackgroundMedication is the most prevalent therapeutic intervention in patient management.1 Medication errors are incidents that have occurred in the medication cycle of prescribing, dispensing, administering, monitoring, or providing medicines advice, regardless of whether they caused harm.1 In a hospital setting, medication error rates are similar amongst adults and children but there is three times the potential to cause harm in the latter. Due to the complexities that are associated with prescribing for children and the potential for the lack of necessary metabolic reserves to buffer any consequences,2 ensuring high quality prescribing in paediatrics is paramount and this requires multidisciplinary team (MDT) collaboration. Pharmacy contributions: The introduction of weekly Safety Huddles was started on the Paediatric Intensive Care Unit (PICU) in March 2017 – led by the PICU consultant, paediatric risk nurse and pharmacist. Safety Huddles are short MDT briefings, involving the ward-based medical, nursing & pharmacy teams, providing a platform for all staff to understand things that are happening within the ward and anticipate further risks to improve patient safety and care. The aim is to create an open environment where staff regularly communicate and feel safe to raise concerns about patient safety. The Safety Huddle comprises of three main aspects: pharmacy updates as ‘top tips’; Datix incident reports and issues/concerns of the week. Pharmacy interventions are collected on a daily basis and fed back to the individual prescriber immediately where possible as the exchange of information must be rapid to optimise engagement. These then form the weekly ‘top tips’ which are shared with the whole MDT, along with Datix reports and any particular concerns where learning and action points are developed and agreed through contribution by all.OutcomeThe concept of Safety Huddles has been adapted and fully established throughout all paediatric and neonatal specialities at the Trust. There has been an increase in the number of incidents reported since the implementation of the Safety Huddles. Error themes and their impact are looked at so the team learn from improvement and harm occurrence or near misses. The measurement of interventions provides a weekly update to the individual team to see if these are being carried out effectively and to improve where necessary. It allows identification of triggers and incorporates problem solving through the involvement of all members of the team, improving staff, patient and family experience and communication in addition to reducing harm, allowing Trust values to be met. Lessons learned: Safety Huddles are held in the spirit of learning and improvement. It allows integration with the wider team, empowering the team to work unanimously towards the ultimate goal of delivering the best patient care.ReferencesDepartment of Health and Social Care. The Report of the Short Life Working Group on reducing medication- related harm. February 2018.Department of Health. Medicines Standard: National Service Framework for Children, Young People and Maternity Services. October 2004. Department of Health. Building a Safer NHS or Patients: Improving Medication Safety. January 2004.

scholarly journals IT’S MY BUDDY: EXPLORING THE PERCEPTIONS OF PEOPLE WITH DEMENTIA ABOUT THE SOCIAL ROBOT PARO IN A HOSPITAL SETTING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S331-S331
Author(s):  
Lillian Hung ◽  
Habib Chaudhury
Keyword(s):  
Older People ◽  
Sense Of Self ◽  
Contextual Information ◽  
New Technology ◽  
Hospital Setting ◽  
Social Robots ◽  
Social Robot ◽  
Structured Interviews ◽  
People With Dementia ◽  
The Social

Abstract New technology such as social robots opens up new opportunities in hospital settings. PARO, a robotic pet seal, was designed to provide emotional and social support for older people with dementia. This project aims to explore the perceptions of persons with dementia about PARO’s role in a hospital setting. Video-ethnographic methods were applied. We had conversational interviews with and video observations of 10 older people with dementia in the geriatric unit of a large Canadian hospital. Also, semi-structured interviews and two focus groups were conducted with 10 staff members in the local unit to gain contextual information. Thematic analysis yielded three substantive themes: (a) “it’s like a buddy”—the robot helps people with dementia uphold a sense of self in the world; (b) “it’s a conversation piece”—the baby seal facilitates social connection; and (c) “it’s all about love”—PARO transforms and humanizes the clinical setting. Our findings help provide a better understanding of the direct perspectives of patients with dementia on the use of social robots. Instead of substituting human contact, the social robot complements emotional care and supports our fundamental human need for love.

ПСИХОЛОГІЧНИЙ СУПРОВІД СТАНОВЛЕННЯ УСПІШНОЇ ОСОБИСТОСТІ У ПРОФЕСІЙНОМУ СЕРЕДОВИЩІ В УМОВАХ СОЦІАЛЬНИХ ТА ОСВІТНІХ РЕФОРМ

1970 ◽  
Vol 8 (1) ◽  
pp. 221-226
Author(s):  
Олена Горова
Keyword(s):  
Social Activity ◽  
Professional Activity ◽  
Subjective Feeling ◽  
Support Worker ◽  
Gainful Employment ◽  
Progressive Development ◽  
Professional Success ◽  
The Social ◽  
The Individual ◽  
Favorable Conditions

Професійне   становлення   особистості   супроводжує   всі   етапи  соціально-вікового   розвитку  особистості.  Трудова  діяльність  є  основним  видом  суспільної  активності,  який  дозволяє  працівнику  задовольняти  основні  потреби,  особливо  у  процесі  постійних  соціальних,  освітніх  реформ.  Важливим  завданням психологічного супроводу працівника у процесі виконання професійної діяльності є забезпечення  сприятливих  умов  формування  професійно  важливих  якостей.  Соціальна  успішність  є  результатом  ефективного  розв’язання  виробничих  завдань, які  мають  суспільно корисну  важливість  та  пов’язані  з  потребами інших людей. Якісний прогресивний розвиток працівника можливий лише за умови збереження  стійкого  позитивного  ставлення  до  професії.  Позитивна  професійна  самоідентифікація  пов’язана  з  ототожненням  та  персоналізацією  працівником  особистісних  рис  працівників,  які  досягли  успіху  у  професії,  мають  суспільно  визнані  результати  діяльності.  Таким  чином,  професійна  успішність  як  суб’єктне  новоутворення  у  якості  відчуття  гордості  за  власні  результати  діяльності  забезпечує  реалізацію традиції наставництва і  передачі позитивного професійного досвіду.    Професійно  успішний  працівник  усвідомлює  необхідність  та  важливість  результатів  своєї  діяльності  для  інших,  що  вимагає,  відповідно,  від  соціального  середовища  усвідомлення  необхідності  визнання  результатів  діяльності  фахівців.  Знехтуваний  суспільством  працівник,  або  той,  результати  діяльності  якого  позиціонуються  як  меншовартісні,  дистанціюється  від  професії  та  має  негативний  потенціал розвитку. Professional formation of the person accompanies all phases of social and age of the individual. Gainful  employment is the main form of social activity that allows the employee to realize the basic needs. An important task  of psychological support worker in the course of professional activity is to provide favorable conditions for the  formation  of  professionally  important  qualities.  Professional  success  is  the  result  of  an  effective  solution  of  industrial jobs that are socially useful and important related to the needs of others. High-quality progressive  development of an employee is only possible while maintaining a stable positive attitude towards the profession.  Positive  professional  identity  associated  with  the  identification  and  personalization  of  employee  personality traits of employees who have been successful in the profession, who have publicly acknowledged  performance. Thus professional success as the subjective feeling of a lump in the pride of their own results of  operations  ensures  the  implementation  of  the  tradition  of  mentoring  and  of  positive  transfer  of  professional  experience.  Professionally successful employees aware of the need and the importance of the results of its operations  for the other, which requires, respectively, from the social environment - awareness of the need to recognize the  performance of specialists. Unclaimed society worker, or the results of operations, which are positioned as less  important, is moving away from the profession and has a negative potential. 

Significados de Morte: o Discurso do Sujeito Coletivo da Enfermagem / Meaning of Death: the collective subject speech of the nursing staff

1970 ◽  
Vol 6 (1) ◽  
pp. 52-58
Author(s):  
Fellipe Afonso de Azevedo ◽  
Noé D’jalma Araújo ◽  
Néliton Célio de Novais ◽  
José Vítor da Silva ◽  
Renato Augusto Passos
Keyword(s):  
Nursing Staff ◽  
Hospital Setting ◽  
Field Research ◽  
Structured Interview ◽  
Minas Gerais ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Emergency Units ◽  
Methodological Guidelines

RESUMOObjetivo: o presente trabalho teve como objetivo identificar os significados de morte emergentes das equipes de enfermagem que atuam nas unidades de Pronto Socorro e Unidade de Terapia Intensiva (UTI) em uma entidade de médio porte situada no Sul de Minas Gerais. Materiais e métodos: estudo de abordagem qualitativa, do tipo descritivo, de campo e transversal. A amostra estudada foi composta de oito enfermeiros, 22 técnicos e quatro auxiliares de enfermagem, totalizando 34 profissionais, sendo utilizado o instrumento de caracterização pessoal e profissional da equipe de enfermagem e o roteiro de entrevista semiestruturada. A amostragem foi proposital. A coleta de dados foi realizada através de entrevista semiestruturada, gravada e transcrita. As diretrizes metodológicas do Discurso do Sujeito Coletivo foram utilizadas para a seleção das ideias centrais e expressões-chave correspondentes, a partir das quais foram extraídos os discursos dos sujeitos, no cenário da instituição hospitalar. Resultados e Discussão: ao analisar o tema “significados de morte”, obtiveram-se as seguintes ideias centrais: “passagem”, “diversos significados”, “fim da vida” e “fim e começo de outra vida”. Conclusão: As concepções acerca do tema morte para os profissionais participantes deste trabalho reforça a necessidade de estudos sobre o tema durante a formação acadêmica. Certos de que irão vivenciar este tipo de situação no dia-a-dia profissional, é preciso prepará-los psicologicamente para isso.Palavras-chave: Morte, Equipe de enfermagem, Assistência ao paciente.ABSTRACTObjective: This study aimed to identify the meanings of emerging death of the nursing staff working in the Emergency Units and Intensive Care Unit (ICU) in a medium-sized entity located in southern Minas Gerais. Materials and methods: A cross-sectional qualitative field research. The sample was composed of 8 nurses, 22 technicians and 4 nursing assistants, totaling 34 professionals. It was used a tool of personal and professional characterization of the nursing team and a semi-structured interview. Sampling was intentional. Data collection was conducted through semi-structured interviews, that were recorded and transcribed. The methodological guidelines of the Collective Subject Speech were used for the selection of the central ideas and corresponding key expressions, from which the speeches of the subjects were taken, in the hospital setting. Results and discussion: to examine the topic "death meanings" yielded the following core ideas: "pass", "different meanings", "end of life" and "end and beginning of another life." Conclusion: The conceptions about the death theme for the professional participants of this study reinforces the need for studies on the subject during their academic training. It is certain that they will experience this type of situation on their daily professional routine, therefore there is a need to prepare them psychologically for this.Keywords: Death, Nursing staff, Patient care.

scholarly journals A Multiple Stakeholder Perspective for Evaluating Community-Based Dementia Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 60-61
Author(s):  
Johan Suen
Keyword(s):  
Dementia Care ◽  
Structural Constraints ◽  
Care Provision ◽  
Care Providers ◽  
Structured Interviews ◽  
Community Based ◽  
Relational Factors ◽  
Care Relationships ◽  
The Individual ◽  
The Impact

Abstract For holistic interventions and research on dementia, it is fundamental to understand care experiences from the perspectives of carers, care recipients, and care professionals. While research on care dyads and triads have highlighted the effects of communication and interactional aspects on care relationships, there is a lack of knowledge on how individual-contextual and relational factors shape the provision and receipt of care in terms of decision-making processes, resource allocation, and expectations of care outcomes. Thus, this paper sheds light on (i) how carers negotiate care provision with other important life domains such as employment, household/family roles and conflicts, as well as their own health problems, life goals, values, and aspirations for ageing; (ii) how older adults with dementia perceive support and those who provide it; (iii) the structural constraints faced by care professionals in delivering a team-based mode of dementia care; and, taken together, (iv) how community-based dementia care is impeded by barriers at the individual, relational, and institutional levels. Findings were derived from semi-structured interviews and observational data from fieldwork conducted with 20 persons with dementia (median age = 82), 20 of their carers (median age = 60), and 4 professional care providers. All respondents were clients and staff of a multidisciplinary and community-based dementia care system in Singapore. Our analysis indicates the impact of dementia care is strongly mediated by the interplay between institutional/familial contexts of care provision and the various ‘orientations’ to cognitive impairment and seeking support, which we characterised as ‘denial/acceptance’, ‘obligated’, ‘overprotective’, and ‘precariously vulnerable’.

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.

scholarly journals Developing HIV assisted partner notification services tailored to Mexican key populations: a qualitative approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heleen Vermandere ◽  
Santiago Aguilera-Mijares ◽  
Liliane Martínez-Vargas ◽  
M. Arantxa Colchero ◽  
Sergio Bautista-Arredondo
Keyword(s):  
Partner Notification ◽  
Key Populations ◽  
Structured Interviews ◽  
Hiv Diagnosis ◽  
Serostatus Disclosure ◽  
Hiv Epidemic ◽  
Contact Information ◽  
Hiv Awareness ◽  
Sex With Men ◽  
The Individual

Abstract Background Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). This study aimed to explore the awareness of and need for HIV partner notification, as well as to outline potential strategies for APNS based on identified barriers and facilitators. Methods We conducted semi-structured interviews to explore partner notification with MSM, TW, and counselors. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. Results Most participants reported experiences with informal partner notification and serostatus disclosure, but not with APNS. Only one counselor indicated assisting notification systematically. The main barriers for notifying or disclosing mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier to inform a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counselors or peers to mitigate potential rejection or violent reactions. Conclusions While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS could potentially enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

Development of an Industry Test Facility and Qualification Process for ILI Technology Evaluation and Enhancements: Performance Evaluation Phase

2018 ◽  
Author(s):  
Pablo Cazenave ◽  
Ming Gao ◽  
Hans Deeb ◽  
Sean Black
Keyword(s):  
Performance Evaluation ◽  
Technology Development ◽  
New Technology ◽  
Test Facility ◽  
Technology Evaluation ◽  
Team Members ◽  
Integrity Assessment ◽  
Evaluation Phase ◽  
The Individual ◽  
Pull Tests

The project “Development of an Industry Test Facility and Qualification Processes for in-line inspection (ILI) technology Evaluation and Enhancements” aims to expand knowledge of ILI technology performance and identify gaps where new technology is needed. Additionally, this project also aims to provide ILI technology developers, researchers and pipeline operators a continuing resource for accessing test samples with a range of pipeline integrity threats and vintages; and inline technology test facilities at the Technology Development Center (TDC) of Pipeline Research Council International, Inc. (PRCI), a PRCI managed facility available for future industry and PHMSA research projects. An ILI pull test facility was designed and constructed as part of this project based on industry state-of-the-art and opportunities for capability improvement. The major ILI technology providers, together with pipeline operator team members, reviewed the TDC sample inventory and developed a series of ILI performance tests illustrating one of multiple possible research objectives, culminating in 16-inch and 24-inch nominal diameter test strings. The ILI technology providers proposed appropriate inspection tools based on the types of the integrity threats in the test strings, a series of pull tests of the provided ILI tools were performed, and the technology providers delivered reports of integrity anomaly location and dimensions for performance evaluation. Quantitative measures of detection and sizing performance were confidentially disclosed to the individual ILI technology providers. For instances where ILI predictions were outside of claimed performance, the vendors were given a limited sample of actual defect data to enable re-analysis, thus demonstrating the potential for improved integrity assessment with validation measurements. In this paper, an evaluation of the ILI data obtained from repeated pull-through testing on the 16 and 24-inch pipeline strings at the TDC is performed. The resulting data was aligned, analyzed, and compared to truth data and the findings of the evaluation are presented.

A Qualitative Study of Developing Competency in Thyroid Surgery: A Resident’s Perspective With 5 Year Follow Up

2021 ◽  
pp. 000348942199691
Author(s):  
Gabriela DeVries ◽  
Megan Rudolph ◽  
Howard David Reines ◽  
Philip E. Zapanta
Keyword(s):  
Qualitative Study ◽  
Learning Strategies ◽  
Thyroid Surgery ◽  
Washington Dc ◽  
Structured Interviews ◽  
Self Directed Learning ◽  
Surgical Specialty ◽  
Long Term Follow Up ◽  
The Individual

Objectives: The Accreditation Council for Graduate Medical Education has guidelines on assessing surgical qualifications based on experience. Attending surgeons have various assumptions on how their trainees learn and acquire surgical skills. This study primarily investigates the resident’s perspective on gaining experience and achieving competency in thyroid surgical procedures. Methods: A qualitative study using semi-structured interviews was designed to derive themes that discuss the acquisition of competency in thyroid surgery. After IRB approval, data was collected from 2012 to 2014 at 4 academic centers in the Washington, DC area. Fourteen chief residents specializing in either general surgery or otolaryngology were interviewed until saturation was achieved. These semi-structured interviews were transcribed and broken up into codes utilizing Moustakas’ analysis. A comprehensive list of master themes in regards to achieving competency in thyroid surgery was developed. A follow up survey of the surgeons was undertaken at 5 years to determine if the perceptions during residency persisted in practice. Results: Surgical specialty residents experience and learn thyroid surgery in 5 learning themes: 1. Self—directed learning is significant during residency. 2. Repetition with graduated autonomy is key. 3. Effective mentors are competent surgeons who challenge residents and use positive teaching techniques. 4. Residents employ active learning through the “see one, do one, teach one” philosophy. 5. Learning from complexity is of importance to residency training. After several years in practice, the most important theme in learning after residency was repetition of cases. Conclusions: This study demonstrates how residents progress in approaching competency in thyroid surgery. Adult learning strategies are preferred, and programs should incorporate tailored techniques to meet the individual needs of the residents. Perceptions of what is most important shifted in long-term follow up. Further study is needed to assure competency in residency and in practice.

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