scholarly journals Management of ophthalmic surgical instruments and processes optimization: mixed method study

2020 ◽  
Vol 41 ◽  
Author(s):  
Daniela Silva dos Santos Schneider ◽  
Ana Maria Müller de Magalhães ◽  
Cecilia Helena Glanzner ◽  
Elisabeth Gomes da Rocha Thomé ◽  
João Lucas Campos de Oliveira ◽  
...  
Keyword(s):  
Mixed Method ◽  
Qualitative Approach ◽  
Surgical Instruments ◽  
University Hospital ◽  
Mixed Method Study ◽  
Southern Brazil ◽  
Material Management ◽  
Aim Analysis ◽  
Management Method ◽  
Definition Of

ABSTRACT Aim: Analysis of the use of ophthalmic instruments during surgical procedures in order to propose a material management method. Method: Mixed method study, sequential exploratory design, performed from January to June 2015, at a university hospital in southern Brazil. First, a qualitative approach was held from brainstorming and field observation. Themes were grouped into thematic categories. By connection, the quantitative stage happened through matrix arrangement and linear programming, culminating in the instrument management proposal. Results: Given categories - instruments reorganization according to the time of the surgical procedure and the need surgical instruments for in each procedure - guided the definition of existing restrictions and application of mathematical models. There was an average reduction of 13.10% in the number of surgical instruments per tray and an increase of 17.88% in surgical production. Final considerations: This proposal allowed the rationalization and optimization of ophthalmic instruments, favoring sustainability of the organization.

scholarly journals Preventing ventilator-associated pneumonia—a mixed-method study to find behavioral leverage for better protocol adherence

2018 ◽  
Vol 39 (10) ◽  
pp. 1222-1229 ◽  
Author(s):  
Aline Wolfensberger ◽  
Marie-Theres Meier ◽  
Lauren Clack ◽  
Peter W. Schreiber ◽  
Hugo Sax
Keyword(s):  
Focus Group ◽  
Mixed Method ◽  
University Hospital ◽  
Mixed Method Study ◽  
Ventilator Associated Pneumonia ◽  
Theory Approach ◽  
Prevention Measures ◽  
Focus Group Interviews ◽  
Protocol Adherence ◽  
Group Interviews

AbstractObjectivePreventing ventilator-associated pneumonia (VAP) is an important goal for intensive care units (ICUs). We aimed to identify the optimal behavior leverage to improve VAP prevention protocol adherence.DesignMixed-method study using adherence measurements to assess 4 VAP prevention measures and qualitative analysis of semi-structured focus group interviews with frontline healthcare practitioners (HCPs).SettingThe 6 ICUs in the 900-bed University Hospital Zurich in Zurich, Switzerland.Patients and participantsAdherence to VAP prevention measures were assessed in patients with a device for invasive ventilation (ie, endotracheal tube, tracheostomy tube). Participants in focus group interviews included a convenience samples of ICU nurses and physicians.ResultsBetween February 2015 and July 2017, we measured adherence to 4 protocols: bed elevation showed adherence at 27% (95% confidence intervals [CI], 23%–31%); oral care at 41% (95% CI, 36%–45%); sedation interruption at 81% (95% CI, 74%–85%); and subglottic suctioning at 88% (95% CI, 83%–92%). Interviews were analyzed first inductively according a grounded theory approach then deductively against the behavior change wheel (BCW) framework. Main behavioral facilitators belonged to the BCW component ‘reflective motivation’ (ie, perceived seriousness of VAP and self-efficacy to prevent VAP). The main barriers belonged to ‘physical capability’ (ie, lack of equipment and staffing and side-effects of prevention measures). Furthermore, 2 primarily technical approaches (ie, ‘restructuring environment’ and ‘enabling HCP’) emerged as means to overcome these barriers.ConclusionsOur findings suggest that technical, rather than education-based, solutions should be promoted to improve VAP prevention. This theory-informed mixed-method approach is an effective means of guiding infection prevention efforts.

Digital Dashboard for Improving Pharmacy Management: A mixed-method study

2021 ◽  
Author(s):  
Arezoo Dehghani Mahmoodabadi ◽  
Mostafa langarizadeh ◽  
Mohammad Hossein Mosaddegh Mehrjardi ◽  
Sima Emadi
Keyword(s):  
Mixed Method ◽  
Performance Indicators ◽  
Delphi Technique ◽  
Qualitative Approach ◽  
Decision Makers ◽  
Mixed Method Study ◽  
Financial Indicators ◽  
Framework Analysis ◽  
Hospital Pharmacies ◽  
Structured Questionnaire

Aim: This study aimed to determine the performance indicators required for hospital pharmacies and design a hospital pharmacy dashboard through defining requirements. Methods: This study was conducted in three phases in 2017. A qualitative approach was employed to collect and formulate key performance indicators (KPIs) for hospital pharmacies. A semi-structured questionnaire was constructed to determine KPIs. The data were analyzed using framework analysis. The classic Delphi technique was used to determine the dashboard requirements. Finally, the Dashboard was designed using QlikView12 and implemented in the selected hospital. The data displayed on the pharmacy dashboard was driven by the hospital information system (HIS). Results: The KPIs consisted of three domains including managerial, clinical, and financial indicators. Conclusion: Pharmacy services have been affected by the complexity and diversity of drugs, clinical concerns, and costs. The dashboard can help pharmacies' managers by monitoring. The dashboard design process begins by identifying KPIs that are important to decision-makers.

scholarly journals Time for cleaning and room preparation: connection between surgery size and professional perspectives

2014 ◽  
Vol 35 (1) ◽  
pp. 131-139
Author(s):  
Marla Andréia Garcia de AVILA ◽  
Suzimar de Fátima Benato FUSCO ◽  
Ivana Regina GONÇALVES ◽  
Sílvia Maria CALDEIRA ◽  
Carlos Roberto PADOVANI ◽  
...  
Keyword(s):  
Content Analysis ◽  
Mixed Method ◽  
Qualitative Approach ◽  
Surgical Instruments ◽  
Thematic Content Analysis ◽  
Thematic Content ◽  
Institutional Goals ◽  
Significant Difference ◽  
Professional Perspectives ◽  
Surgical Teams

The objective was to verify the association between time needed for room cleaning (TLPS) and the surgery size, and related advantages and difficulties faced by the circulator of the room assigned to this task. A mixed method, with a transverse quantitative, retrospective approach, using a sample of 3095 surgeries performed, from January to June 2011, and a qualitative approach using a Thematic Content Analysis of statements from 11 circulators, was used. The average TLPS was smaller in size 1 surgeries, increasing in sizes 2, 3 and 4, with a significant difference. Advantages reported included organization and size of staff, and difficulties reported related to sharp, bladed materials mixed with surgical instruments and a reduced number of cleaning professionals. The larger the size, the higher the TLPS. Surgical teams operating in the Surgical Center interfere directly in the process, facilitating or hindering the achievement of institutional goals related to quality and productivity.

scholarly journals PERCEPTION OF NURSING PROFESSIONALS ABOUT PATIENT CARE OF THE TERMINALLY ILL IN THE HOSPITAL ENVIRONMENT

2016 ◽  
Vol 25 (3) ◽  
Author(s):  
Tânia Cristina Schäfer Vasques ◽  
Valéria Lerch Lunardi ◽  
Priscila Arruda da Silva ◽  
Karen Knopp de Carvalho ◽  
Wilson Danilo Lunardi Filho ◽  
...  
Keyword(s):  
Exploratory Study ◽  
Terminal Illness ◽  
Qualitative Approach ◽  
University Hospital ◽  
Hospital Environment ◽  
Southern Brazil ◽  
Structured Interviews ◽  
Family Presence ◽  
Loved One ◽  
Nursing Professionals

ABSTRACT This study aimed to understand how nursing professionals perceive the care provided to patients with terminal illness in the hospital environment. This was an exploratory study with a qualitative approach, conducted with 23 professionals in the ambulatory service of a university hospital in southern Brazil. Semi-structured interviews were used for data collection, in 2011. Using discursive textual analysis, dialogue was shown to be a fundamental instrument in caring for patients in terminal illness, enabling the facilitation of the difficulties experienced by these patients and their families. The importance of family presence for these patients was identified, making it indispensable for caring for their loved one. Continuous education of the staff is necessary, using problematization of the difficulties experienced in the workplace, humanizing and qualifying the nursing care, ensuring dignity and comfort to patients and their families.

scholarly journals CARE IN THE PARTURITION PROCESS FROM THE PERSPECTIVE OF NURSING PROFESSIONALS

2020 ◽  
Vol 29 ◽  
Author(s):  
Adriana Aparecida Piler ◽  
Marilene Loewen Wall ◽  
Tatiane Herreira Trigueiro ◽  
Deisi Cristine Forlin Benedet ◽  
Juliane Dias Aldrighi ◽  
...  
Keyword(s):  
Human Resources ◽  
Nursing Care ◽  
Thematic Analysis ◽  
Group Discussion ◽  
Qualitative Approach ◽  
University Hospital ◽  
Care Process ◽  
Southern Brazil ◽  
Convergence Group ◽  
Nursing Professionals

ABSTRACT Objective: to reflect on nursing care for women undergoing parturition from the perspective of nursing professionals. Method: this is a study with a qualitative approach based on Convergent Care Research. The participants were 36 nursing professionals, who developed assistance activities for women undergoing parturition in an Obstetric and Gynecological Surgical Center of a University Hospital in southern Brazil. For data collection, the convergence group discussion technique was used, through audio-recorded thematic workshops following the phases of the process called Four Rs (4Rs), from June to August 2017. The data were analyzed using the thematic analysis proposed by Creswell, supported by the Iramuteq software. Results: five classes emerged: weaknesses/limitations in the parturition process; ambience and human resources in the parturition process; imposition of care and lack of privacy for women in the parturition process; process of being born: the understanding of nursing professionals; and contributions in the care process for a better birth. Conclusion: the present study allowed understanding the relationships of the nursing care for women in the process of parturition, identifying the barriers and weaknesses in the care process, reflecting and discussing possibilities for the systematization of nursing care in the parturition process.

Safety culture in a nephrology service at a university hospital: A mixed method study

2021 ◽  
Author(s):  
Nínive Pita Gomes de Oliveira ◽  
Joyce Martins Arimatéa Branco Tavares ◽  
Cintia Silva Fassarella ◽  
Priscilla Alfradique de Souza ◽  
Sílvia Maria de Sá Basílio Lins
Keyword(s):  
Safety Culture ◽  
Mixed Method ◽  
University Hospital ◽  
Mixed Method Study

scholarly journals Classificação de risco em emergência – um desafio para as/os enfermeiras/os

2011 ◽  
Vol 2 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Lícia Mara Brito Shiroma ◽  
Denise Elvira Pires De Pires
Keyword(s):  
Emergency Room ◽  
Patient Care ◽  
Exploratory Study ◽  
Qualitative Approach ◽  
Point Of View ◽  
University Hospital ◽  
Southern Brazil ◽  
Structured Interviews ◽  
Care Health ◽  
The Voice

Estudo descritivo e exploratório de abordagem qualitativa com o objetivo de conhecer a visão das/os enfermeiras/os acerca da implantação do Acolhimento com Avaliação e Classificação de Risco (AACR) em serviços de emergência. Os dados foram coletados através de entrevistas semiestruturadas com enfermeiras/os de um hospital universitário do sul do Brasil. Na voz das/os enfermeiras/os, AACR significa reorganização do atendimento e possibilidade de proporcionar melhor humanização, acesso e resposta satisfatória ao usuário em estado grave. Conclui que o AACR contribui para a agilidade e segurança no atendimento aos usuários e para diminuir a sobrecarga de trabalho da equipe.Descritores: Humanização da Assistência, Sistemas de Saúde, Políticas Públicas, Acolhimento.Risk classification in emergency room – a challenge to nursesThat is a descriptive and exploratory study of qualitative approach in order to know the nurses’ point of view about the User Embracement with Evaluation and Risk Classification (AACR) in ER. Data were collected through semi-structured interviews with nurses of a university hospital in southern Brazil. In the voice of nurses, AACR means reorganization of care and to provide a better humanization, access and satisfactory response to the user in serious condition. It concludes that the AACR contributes to the agility and safety in patient care and decrease the workload of the team.Descriptors: Humanization of Care, Health Systems, Public Policies, User Embracement.La clasificación del riesgo en el servicio de emergencia – un desafio para los enfermerosSe trata de estudio descriptivo y exploratorio con abordaje cualitativa con el objetivo de conocer la opinión de las enfermeras sobre la implantación de Acogimiento con la Evaluación y Classificación de Riesgos (AACR) en servicios de emergencia. Los datos fueron recolectados a través de entrevistas semi-estructuradas con enfermeras de un hospital universitario en el sur de Brasil. En la voz de las enfermeras, AACR significa la reorganización de la atención y la posibilidad de proporcionar mejor humanización, el acceso y la respuesta satisfactoria al usuario en estado grave. Se concluye que la AACR contribuye a la agilidad y la seguridad en el servicio al cliente y reducir la carga de trabajo del equipo.Descriptores: Humanización de la Atención, Sistemas de Salud, Políticas Públicas, Acogimiento.

scholarly journals Factors and experiences associated with unscheduled 30-day hospital readmission: A mixed method study

2021 ◽  
Vol 50 (10) ◽  
pp. 751-764
Author(s):  
Amartya Mukhopadhyay ◽  
Bhuvaneshwari Mohankumar ◽  
Lin Siew Chong ◽  
Zoe J-L Hildon ◽  
Bee Choo Tai ◽  
...  
Keyword(s):  
Mixed Method ◽  
Hospital Readmission ◽  
Hospital Readmissions ◽  
Emergency Department Visits ◽  
University Hospital ◽  
Resource Utilisation ◽  
Mixed Method Study ◽  
Healthcare Team ◽  
Neoplastic Disease ◽  
Related Factors

ABSTRACT Introduction: Analysis of risk factors can pave the way for reducing unscheduled hospital readmissions and improve resource utilisation. Methods: This was a concurrent nested, mixed method study. Factors associated with patients readmitted within 30 days between 2011 and 2015 at the National University Hospital, Singapore (N=104,496) were examined. Fifty patients were sampled in 2016 to inform an embedded qualitative study. Narrative interviews explored the periods of readmissions and related experiences, contrasted against those of non-readmitted patients. Results: Neoplastic disease (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.70–2.15), number of discharged medications (5 to 10 medications OR 1.21, 95% CI 1.14–1.29; ≥11 medications OR 1.80, 95% CI 1.66–1.95) and length of stay >7 days (OR 1.46, 95% CI 1.36–1.58) were most significantly associated with readmissions. Other factors including number of surgical operations, subvention class, number of emergency department visits in the previous year, hospital bill size, gender, age, Charlson comorbidity index and ethnicity were also independently associated with hospital readmissions. Although readmitted and non-readmitted patients shared some common experiences, they reported different psychological reactions to their illnesses and viewed hospital care differently. Negative emotions, feeling of being left out by the healthcare team and perception of ineffective or inappropriate treatment were expressed by readmitted patients. Conclusion: Patient, hospital and system-related factors were associated with readmissions, which may allow early identification of at-risk patients. Qualitative analysis suggested several areas of improvement in care including greater empowerment and involvement of patients in care and decision making. Keywords: Comorbidity, diagnosis, hospital readmission, qualitative evaluation, socioeconomic factors

scholarly journals How to design Lean interventions to enable impact, sustainability and effectiveness. A mixed-method study

2015 ◽  
Vol 4 (5) ◽  
pp. 18 ◽  
Author(s):  
Hege Andersen
Keyword(s):  
Mixed Method ◽  
Organisational Change ◽  
Goal Achievement ◽  
University Hospital ◽  
Future Research ◽  
Mixed Method Study ◽  
Multidisciplinary Teams ◽  
Top Management ◽  
Work Processes ◽  
Use Of Time

Objective: This study’s aim was to assess how various organisational designs affect Lean interventions’ success. Refinement of design and analytics contributes to the knowledge of organisational change management, and promote sound investment in quality improvement.Methods: A panel of 11 experienced Lean consultants ranked the success of 17 Lean interventions implemented at a university hospital. This was done by assessing their impact on outcome, the sustainability of the improved work processes and the effectiveness regarding degree of goal achievement. The potential relationship between the interventions’ rank, organisation, targets for improvement, and use of time and resources, was analysed by a linear mixed model.Results: 30 percent of the interventions were assessed as successful, 60 percent as moderately successful, and 10 percent as unsuccessful. Employee and safety-staff representation (β 0.22 [CI 0.07–0.37]), top management attendance (β 0.14 [CI 0.10–0.18]), patient-related goals (β 0.13 [CI 0.06–0.20]) and hours in work-groups (β 0.01 [CI 0.00–0.01]) were related to impact on outcome. Interventions that ranged across divisions (β -0.45 [CI -0.75– -0.19]), employee and safety-staff representation (β 0.44 [CI 0.29–0.60]), comprehensive project organisation (β 0.22 [CI 0.08–0.36]) and patient-related goals (β 0.18 [CI 0.11–0.26]) were related to sustainability. Interventions that ranged across divisions (β -1.39 [CI -1.96– -0.81]), comprehensive project organisation (β 0.30 [CI 0.18–0.43]), employee and safety-staff representation (β 0.25 [CI 0.89–0.41]), limited top-management attendance (β -0.18 [CI -0.28– -0.08]), multi-disciplinary teams composed of several professions (β 0.16 [CI 0.08–0.24]) and patient-related goals (β 0.15 [CI 0.04–0.19]) were all related to a higher degree of effectiveness.Conclusions: To achieve quality improvement in hospitals, policymakers are advised to invest in time and a comprehensive project organisation. Furthermore, the interventions should engage multidisciplinary teams including employee and safety-staff representatives and pursue improvement for patients, across divisions. The methods applied constitute a framework for future research.

scholarly journals REPERCUSSIONS IN THE LIVING PROCESS OF PEOPLE WITH STOMAS

2016 ◽  
Vol 25 (1) ◽  
Author(s):  
Marina Soares Mota ◽  
Giovana Calcagno Gomes ◽  
Vilma Madalosso Petuco
Keyword(s):  
Self Care ◽  
Descriptive Study ◽  
Qualitative Approach ◽  
University Hospital ◽  
Support Network ◽  
Southern Brazil ◽  
Structured Interviews ◽  
First Semester ◽  
Living Process

A descriptive study with a qualitative approach that aimed to identify the repercussions of ostomy construction on the living process of people with an ostomy. The study was performed at a Stomatherapy Service from a university hospital in southern Brazil, in the first semester of 2011, with eight patients. Data were collected through semi-structured interviews, and they were analyzed by thematic analysis. We found that the surgery happened to prevent patient deaths. Patients presented themselves as disheartened, angry, sad, having doubts, and they sought to keep the ostomy a secret. They were concerned with the acquisition of resources for self-care. They may present complications and experience embarrassing situations because of the stoma. However, they perceived that they could live with a stoma and regain joy. We concluded that they were able to reframe their lives. We highlight the role of nurses, enabling them for self-care, constituting part of their social support network, helping them to become able to live independently.

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