scholarly journals Dificuldades na aplicação do checklist cirúrgico: estudo qualitativo de abordagem ecológica restaurativa

2018 ◽  
Vol 16 (4) ◽  
pp. 448
Author(s):  
Nery José de Oliveira Junior ◽  
Ana Maria Müller de Magalhães
Keyword(s):  
Patient Safety ◽  
Qualitative Study ◽  
Focus Groups ◽  
Ecological Approach ◽  
Medical Team ◽  
Southern Brazil ◽  
Safe Surgery ◽  
Time Out ◽  
Main Factors

Aim: analyze the application of the safe surgery checklist, seeking to describe the main factors that can affect its completion and follow-up, according to the perception of nursing technicians. Method: this is a qualitative study performed with nursing technicians from an outpatient surgical center in southern Brazil. The data were collected through focus groups and photographic methods, from the perspective of ecological and restorative thinking. Results: three categories emerged from the information grouping: Checklist for patient safety – still a challenge; difficulty of adherence to the safe surgery checklist; and Checklist Steps. Discussion: the data indicate that some stages of this process are still not met and there is difficulty of adherence by the teams. Conclusions: among the main failures is the low adherence of the medical team to perform the time out and to the confirmation of the place and the procedure. The restorative ecological approach made it possible to engage professionals.

scholarly journals 'I can't cope with multiple inputs': Qualitative study of the lived experiences of 'brain fog' after Covid-19

2021 ◽  
Author(s):  
Caitriona Callan ◽  
Emma Ladds ◽  
Laiba Hussain ◽  
Kyle Pattinson ◽  
Trish Greenhalgh
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Lived Experience ◽  
Support Groups ◽  
Online Support ◽  
Online Support Groups ◽  
Physical Mechanisms ◽  
Neurocognitive Impairments ◽  
Specialist Services

Objective To explore the lived experience of brain fog i.e the wide variety of neurocognitive symptoms that can follow Covid-19. Design and setting UK wide longitudinal qualitative study comprising online interviews and focus groups with email follow-up. Method 50 participants were recruited from a previous qualitative study of the lived experience of long Covid (n = 23) and online support groups for people with persistent neurological problems following Covid-19 (n = 27). In remotely held focus groups, participants were invited to describe their cognitive symptoms and comment on others accounts. Individuals were followed up by email 4-6 months later. Data were audiotaped, transcribed, anonymised and coded in NVIVO. They were analysed by an interdisciplinary team with expertise in general practice, clinical neuroscience, the sociology of chronic illness and service delivery, and checked by three people with lived experience of brain fog. Results 84% of participants were female and 60% were White British ethnicity. Most had never been hospitalised for Covid-19. Qualitative analysis revealed the following themes: mixed views on the appropriateness of the term brain fog; rich descriptions of the experience of neurocognitive impairments (especially executive function, attention, memory and language), accounts of how the illness fluctuated, and in some but not all cases, resolved, over time; the profound psychosocial impact of the condition on relationships, personal and professional identity; self-perceptions of guilt, shame and stigma; strategies used for self-management; challenges accessing and navigating the healthcare system; and participants search for physical mechanisms to explain their symptoms. Conclusion These qualitative findings complement research into the epidemiology and underlying pathophysiological mechanisms for neurological symptoms after Covid-19. Services for such patients should include: an ongoing therapeutic relationship with a clinician who engages with the illness in its personal, social and occupational context as well as specialist services that are accessible, easily navigable, comprehensive, and interdisciplinary.

scholarly journals Users’ Assessement of the Visualization with Gauges of a Guideline-Based Decision Support System Output: A Qualitative Study of Focus Groups

2021 ◽  
Author(s):  
Abir Abdellatif ◽  
Jacques Bouaud ◽  
Mélissa Tholomier ◽  
Joël Belmin ◽  
Brigitte Seroussi
Keyword(s):  
Decision Support ◽  
Qualitative Study ◽  
Focus Groups ◽  
Pressure Ulcer ◽  
Clinical Practices ◽  
Computerized Decision Support ◽  
Usability Problems ◽  
System Output ◽  
Computerized Decision Support Systems

Computerized decision support systems (CDSSs) are still poorly routinely implemented in clinical practices mainly because of usability problems related to the technology interface. We previously proposed to use gauges to visualize the output of a guideline-based CDSS applied to malnutrition and pressure ulcer management in nursing homes. This interface was assessed by four focus groups including 16 healthcare professionals with expertise in geriatrics. A USE-like questionnaire was distributed. Participants considered the dashboard-with-gauges visualization was useful (94%), easy to use (63%), easy to learn (88%), and 88% thought they could be satisfied with it. However, concerns were expressed about the difficulty to follow up multiple healthcare problems.

scholarly journals Implementation strategies in the context of medication reconciliation: a qualitative study

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Deonni P. Stolldorf ◽  
Sheila H. Ridner ◽  
Timothy J. Vogus ◽  
Christianne L. Roumie ◽  
Jeffrey L. Schnipper ◽  
...  
Keyword(s):  
Patient Safety ◽  
Qualitative Study ◽  
Focus Groups ◽  
Medication Reconciliation ◽  
Complex Interventions ◽  
Implementation Strategies ◽  
Professional Roles ◽  
Roles And Responsibilities ◽  
Individual Interviews ◽  
Professional Roles And Responsibilities

Abstract Background Medication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. Yet, the implementation and sustainability of MedRec interventions have been challenging due to contextual barriers like the lack of interprofessional communication (among pharmacists, nurses, and providers) and limited organizational capacity. How to best implement MedRec interventions remains unclear. Guided by the Expert Recommendations for Implementing Change (ERIC) taxonomy, we report the differing strategies hospital implementation teams used to implement an evidence-based MedRec Toolkit (the MARQUIS Toolkit). Methods A qualitative study was conducted with implementation teams and executive leaders of hospitals participating in the federally funded “Implementation of a Medication Reconciliation Toolkit to Improve Patient Safety” (known as MARQUIS2) research study. Data consisted of transcripts from web-based focus groups and individual interviews, as well as meeting minutes. Interview data were transcribed and analyzed using content analysis and the constant comparison technique. Results Data were collected from 16 hospitals using 2 focus groups, 3 group interviews, and 11 individual interviews, 10 sites’ meeting minutes, and an email interview of an executive. Major categories of implementation strategies predominantly mirrored the ERIC strategies of “Plan,” “Educate,” “Restructure,” and “Quality Management.” Participants rarely used the ERIC strategies of finance and attending to policy context. Two new non-ERIC categories of strategies emerged—“Integration” and “Professional roles and responsibilities.” Of the 73 specific strategies in the ERIC taxonomy, 32 were used to implement the MARQUIS Toolkit and 11 new, and non-ERIC strategies were identified (e.g., aligning with existing initiatives and professional roles and responsibilities). Conclusions Complex interventions like the MARQUIS MedRec Toolkit can benefit from the ERIC taxonomy, but adaptations and new strategies (and even categories) are necessary to fully capture the range of approaches to implementation.

scholarly journals Adaptation of TECCU App Based on Patients´ Perceptions for the Telemonitoring of Inflammatory Bowel Disease: A Qualitative Study Using Focus Groups

2020 ◽  
Vol 17 (6) ◽  
pp. 1871 ◽  
Author(s):  
Javier Del Hoyo ◽  
Pilar Nos ◽  
Raquel Faubel ◽  
Guillermo Bastida ◽  
Diana Muñoz ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Qualitative Study ◽  
Focus Groups ◽  
Communication Networks ◽  
Bowel Disease ◽  
Communication Process ◽  
Personalized Feedback ◽  
Data Saturation ◽  
Inflammatory Bowel

Background: Despite the continuous adaptation of eHealth systems for patients with inflammatory bowel disease (IBD), a significant disconnection persists between users and developers. Since non-adherence remains high, it is necessary to better understand the patients’ perspective on telemonitoring for IBD. Accordingly, this study aimed to adapt the TECCU telemonitoring app to the preferences and needs of IBD patients. Methods: A qualitative study was carried out using successive focus groups of IBD patients. Meetings were audio-recorded and a thematic analysis was employed until data saturation was achieved. The first group included patients who had used the TECCU App in a pilot clinical trial, and subsequent meetings included patients with Crohn’s disease and ulcerative colitis recruited from the Spanish Confederation of patient associations. The information collected at each meeting guided consecutive changes to the platform. Results: Data saturation was reached after three focus groups involving a total of 18 patients. Three main themes emerged: (1) platform usability, (2) the communication process, and (3) platform content. All participants indicated that TECCU is easy to use, permitting continuous and personalized feedback. According to patients´ perspectives, the platform was adapted to foster a flexible follow-up and shared decision-making using open and safe communication networks. Many participants appreciated the educational elements and, consequently, the app was connected to reliable and continuously updated webpages. Conclusions: IBD patients valued the usability and personalized monitoring offered by the TECCU App. Improvements in the messaging system and continuously updated educational content were introduced to address patients´ needs and favor their engagement.

scholarly journals P260 Adaptation of TECCU App based on patients’ perceptions for telemonitoring inflammatory bowel disease: A qualitative study using focus groups

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S279-S280
Author(s):  
J Del Hoyo Francisco ◽  
P Nos ◽  
R Faubel ◽  
G Bastida ◽  
D Muñoz ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Qualitative Study ◽  
Focus Groups ◽  
Communication Networks ◽  
Bowel Disease ◽  
Communication Process ◽  
Data Saturation ◽  
Inflammatory Bowel ◽  
Educational Contents

Abstract Background Despite the continuous adaptation of eHealth systems for patients with inflammatory bowel disease (IBD), a significant disconnection persists between users and developers. Since non-adherence remains high, it is necessary to better understand the patients’ perspectives on telemonitoring for IBD. The aim of this study was to adapt the TECCU app to the preferences and needs of IBD patients. Methods A qualitative study was carried out using successive focus groups of IBD patients. Meetings were audio-recorded and a thematic analysis approach was employed until data saturation was achieved. The first group included patients who had used the TECCU app in a pilot clinical trial, and subsequent meetings included patients with Crohn’s disease and ulcerative colitis recruited from the Spanish Confederation of patient associations. The information collected at each meeting guided consecutive changes to the platform. Results Data saturation was reached after 3 focus groups, involving a total of 18 patients. Three main themes emerged: (1) platform usability; (2) the communication process; and (3) contents of the platform. All participants indicated that TECCU is easy to use, permitting continuous and personalised feedback. Nevertheless, the platform was adapted according to the patients′ perspectives to foster a flexible follow-up and shared decision-making, using open and safe communication networks. Many participants appreciated the educational elements and the app was connected to reliable and continuously updated webpages. Conclusion IBD patients valued the usability and personalised monitoring offered by the TECCU App. Improvements in the messaging system and continuous updates of the educational contents were performed to address patients′ needs and favour their engagement.

scholarly journals Percepção dos preceptores e residentes em anestesiologia em relação ao checklist de cirurgia segura

2020 ◽  
Vol 10 (32) ◽  
pp. 33-43
Author(s):  
Ana Katia Soares ◽  
Mayara Daiane Araujo ◽  
Elaine Reda da Silva
Keyword(s):  
Patient Safety ◽  
Descriptive Study ◽  
Sao Paulo ◽  
University Hospital ◽  
Medical Team ◽  
Lifelong Education ◽  
São Paulo ◽  
Operative Surgical Procedures ◽  
Partial Agreement ◽  
Safe Surgery

Este estudo objetivou conhecer a percepção da equipe médica, representada por preceptores e residentes em anestesiologia, sobre o checklist de cirurgia segura. Tratou-se de um estudo descritivo com abordagem quantitativa, realizado entre dezembro e janeiro de 2019 com 24 profissionais (18 preceptotes e 6 residentes em anestesiologia) que atuavam no Centro Cirúrgico de um Hospital Universitário, localizado no interior de São Paulo. Os resultados evidenciaram que embora os profissionais reconheçam a importância do checklist de cirurgia segura, a maioria referiu adesão parcial ao instrumento. Além disso, verifica-se a necessidade de um novo olhar para o instrumento implantado, visto que a somatória de concordância plena e parcial, relacionadas a falta de dados e a falta de clareza das informações, contidas no checklist de cirurgias seguras, ultrapassaram 50%. Logo, a importância da educação permanente para o desenvolvimento de uma cultura de segurança do paciente e também da compreensão da responsabilidade coletiva.Descritores: Segurança do Paciente, Lista de Verificação, Procedimentos Cirúrgicos Operatórios. Perception of preceptors and residents in anesthesiology in relation to safe surgery checklistAbstract: This study aimed to know the perception of the medical team, represented by preceptors and residents in anesthesiology, about the safe surgery checklist. It was a descriptive study with a quantitative approach, carried out between December and January 2019 with 24 professionals (18 precepts and 6 residents in anesthesiology) who worked in the Surgical Center of a University Hospital located in the interior of São Paulo. The results showed that although the professionals recognize the importance of the safe surgery checklist, the majority reported partial adhesion to the instrument. In addition, there is a need for a new look at the implanted instrument, since the sum of full and partial agreement, related to lack of data and lack of clarity of information, contained in the checklist of safe surgeries, surpassed 50% . Therefore, the importance of lifelong education for the development of a culture of patient safety and also the understanding of collective responsibility.Descriptors: Patient Safety, Verification List, Operative Surgical Procedures. Percepción de los preceptores y residentes en anestesiología en relación al checklist de cirugía seguraResumen: Este estudio objetivó conocer la percepción del equipo médico, representada por preceptores y residentes en anestesiología, sobre el checklist de cirugía segura. Se trató de un estudio descriptivo con abordaje cuantitativo, realizado entre diciembre y enero de 2019 con 24 profesionales (18 preceptos y 6 residentes en anestesiología) que actuaban en el Centro Quirúrgico de un Hospital Universitario, ubicado en el interior de São Paulo. Los resultados evidenciaron que aunque los profesionales reconocen la importancia del checklist de cirugía segura, la mayoría refirió adhesión parcial al instrumento. Además, se verifica la necesidad de una nueva mirada al instrumento implantado, ya que la suma de concordancia plena y parcial, relacionadas con la falta de datos y la falta de claridad de las informaciones contenidas en el checklist de cirugías seguras, superaron el 50% . Por lo tanto, la importancia de la educación permanente para el desarrollo de una cultura de seguridad del paciente y también de la comprensión de la responsabilidad colectiva.Descriptores: Seguridad del Paciente, Lista de Comprobación, Procedimientos Quirúrgicos Operativos.

59. General medicine residents' perception of the mini-CEXs

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
S. Malhotra ◽  
R. Hatala ◽  
C.-A. Courneya
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Focus Group ◽  
Qualitative Study ◽  
Focus Groups ◽  
General Medicine ◽  
Clinical History ◽  
Phenomenological Approach ◽  
Medical Teacher ◽  
The Impact

The mini-CEX is a 30 minute observed clinical encounter. It can be done in the outpatient, inpatient or emergency room setting. It strives to look at several parameters including a clinical history, physical, professionalism and overall clinical competence. Trainees are rated using a 9-point scoring system: 1-3 unsatisfactory, 4-6 satisfactory and 7-9 superior. Eight months after the introduction of the mini-CEX to the core University of British Columbia Internal Medicine Residents, a one hour semi-structured focus group for residents in each of the three years took place. The focus groups were conducted by an independent moderator, audio-recorded and transcribed. Using a phenomenological approach the comments made by the focus groups participants were read independently by three authors, organized into major themes. In doing so, several intriguing common patterns were revealed on how General Medicine Residents perceive their experience in completing a mini-CEX. The themes include Education, Assessment and Preparation for the Royal College of Physicians and Surgeons Internal Medicine exam. Resident learners perceived that the mini-CEX process provided insight into their clinical strengths and weaknesses. Focus group participants favored that the mini-CEX experience will benefit them in preparation, and successful completion of their licensing exam. Daelmans HE, Overmeer RM, van der Hem-Stockroos HH, Scherpbier AJ, Stehouwer CD, van der Vleuten CP. In-training assessment: qualitative study of effects on supervision and feedback in an undergraduate clinical rotation. Medical Education 2006; 40(1):51-8. De Lima AA, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher January 2005; 27(1):46-52. DiCicco-Bloom B, Crabtree BF. The Qualitative Research Interview. Medical Education 2006; 40:314-32.

Perceived Facilitators and Barriers to Implementation of a Decision Support Tool for Adolescent Depression and Suicidality Screening: A Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Ana Radovic ◽  
Nathan Anderson ◽  
Megan Hamm ◽  
Brandie George-Milford ◽  
Carrie Fascetti ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
Decision Support Tool ◽  
Depression Screening ◽  
Self Disclosure ◽  
Support Tool ◽  
Adolescent Parent ◽  
Barriers To Implementation

BACKGROUND Screening Wizard (SW) is a technology-based decision support tool aimed at guiding primary care providers (PCPs) to respond to depression and suicidality screens in adolescents. Separate screens assess adolescents’ and parents’ reports on mental health symptoms, treatment preferences, and potential treatment barriers. A detailed summary is provided to PCPs, also identifying adolescent-parent discrepancies. The goal of SW is to enhance decision making to increase utilization of evidence-based treatments. OBJECTIVE We describe a multi-stakeholder qualitative study with adolescents, parents, and providers to understand potential barriers to implementation of SW. METHODS We interviewed 11 parents and 11 adolescents, and conducted 2 focus groups with 17 healthcare providers (PCPs, nurses, therapists, staff) across 2 pediatric practices. Participants described previous experiences with screening for depression and were shown a mock-up of SW and asked for feedback. Interviews and focus groups were transcribed verbatim, and codebooks inductively developed based on content. Transcripts were double-coded, and disagreements adjudicated to full agreement. Completed coding was used to produce thematic analyses of interviews and focus groups. RESULTS We identified five main themes across the interviews and focus groups: (1) parents, adolescents, and pediatric PCPs agree that depression screening should occur in pediatric primary care; (2) there is concern that accurate self-disclosure does not always occur during depression screening; (3) Screening Wizard is viewed as a tool that could facilitate depression screening, and which might encourage more honesty in screening responses; (4) parents, adolescents and providers do not want Screening Wizard to replace mental health discussions with providers; and (5) providers want to maintain autonomy in treatment decisions. CONCLUSIONS We identified that providers, parents, and adolescents all have concerns with current screening practices, mainly regarding inaccurate self-disclosure. They recognized value in SW as a computerized tool that may elicit more honest responses and identify adolescent-parent discrepancies. Surprisingly, providers did not want the SW report to include treatment recommendations, and all groups did not want the SW report to replace conversations with the PCP about depression. While SW was originally developed as a treatment decision algorithm, this qualitative study has led us to remove this component, and instead focus on aspects identified as most useful by all groups. We hope that this initial qualitative work will improve future implementation of SW.

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