scholarly journals Exploring the Impacts of the Beginning of the COVID-19 Pandemic on Critical Care Physicians and the Delivery of Patient Care in Seven Countries: A Qualitative Interview-Based Study

2022 ◽  
Author(s):  
Jeanna Parsons Leigh ◽  
Chloe DeGrood ◽  
Alexandra Dodds ◽  
Francesca Rubulotta ◽  
Emily A. FitzGerald ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Care ◽  
Thematic Analysis ◽  
Policy Development ◽  
Care Physician ◽  
Structured Interviews ◽  
Preparedness Planning ◽  
Pandemic Planning ◽  
Planning Methods ◽  
Open Coding

Abstract Purpose To understand critical care physician experiences across multiple countries with the COVID-19 pandemic to inform future pandemic preparedness planning. Methods In this qualitative study, 16 critical care physicians (from seven countries) identified in convenience, purposive sampling took part in individual semi-structured interviews from April 7, 2020 to August 27, 2020 that captured the first wave of the pandemic. Open coding was conducted by two researchers who facilitated inductive thematic analysis. Results Key themes identified following thematic analysis included: 1) sourcing and implementation of trusted information; 2) health systems-level preparedness with accessible supports; 3) institutional adaptations including changes to patient care; 4) professional safety and occupational wellbeing; 5) triage and restricted visitation policies; and 6) managing personal familial responsibilities. Conclusion Perspectives of critical care physicians are important for ongoing pandemic planning and should be included in future pandemic policy development.

The Pulmonary Artery (Swan-Ganz) Catheter: Evaluation of A Hemodynamic Monitoring Device in Critical Care Medicine

1993 ◽  
Vol 9 (2) ◽  
pp. 202-209 ◽  
Author(s):  
Giuseppe Pagliarello
Keyword(s):  
Critical Care ◽  
Pulmonary Artery ◽  
Patient Care ◽  
Hemodynamic Monitoring ◽  
Scientific Evidence ◽  
Care Physician ◽  
Monitoring Device ◽  
Medical Monitoring ◽  
Critical Care Units ◽  
The Impact

AbstractThe pulmonary artery catheter (PAC) is an invasive hemodynamic monitoring device that is used extensively in critical care units. This technological advance allows the critical care physician and nurse to closely monitor physiological functions at the bedside. There have been no formal evaluations of the impact of this device on patient care. Reviews and observational studies have yielded different conclusions regarding risks and benefits to patients. This has resulted in much editorial comment expressing divergent opinions on the value of the PAC, but there has been no scientific evidence to guide practice and no apparent effect on the use of these devices. The PAC and other medical monitoring devices must be evaluated with respect to their impact on patient care.

scholarly journals Hospital accreditation processes in Saudi Arabia: a thematic analysis of hospital staff experiences

2022 ◽  
Vol 11 (1) ◽  
pp. e001652
Author(s):  
Ali Al Mansour ◽  
Alan F Merry ◽  
Tanisha Jowsey ◽  
Jennifer M Weller
Keyword(s):  
Saudi Arabia ◽  
Patient Care ◽  
Thematic Analysis ◽  
Accreditation Process ◽  
Public Hospitals ◽  
Structured Interviews ◽  
Hospital Accreditation ◽  
Planning Stage ◽  
Quality Of Patient Care

BackgroundHospital accreditation by an international organisation can play an important role in health quality and safety. However, little is known about how managers and front-line employees experience and perceive the effects of accreditation. Their views could inform quality improvement processes and procedures.ObjectiveTo explore perceptions of employees at the managerial level on the Joint Commission International (JCI) accreditation process and its impact on quality of patient care in Saudi Arabian JCI-accredited hospitals.MethodsWe undertook a qualitative study using semi-structured interviews to explore the perspectives of senior staff from three accredited public hospitals in Saudi Arabia. Interviews were transcribed prior to thematic analysis.ResultsTwenty managers participated in the interviews. The following inter-related themes emerged concerning the JCI accreditation process and its impact on quality of patient care: drivers for the change; the plan for the change; the process of the change; maintaining changes post-accreditation and patients’ issues. Participants were positive in their accounts of: drivers for the change; planning for the change needed to achieve accreditation and managing patients’ issues. However, participants reported less favourably on: the process of the change; and maintaining changes post-accreditation.ConclusionThe planning stage was perceived as the easiest component of JCI accreditation. Implementing and maintaining changes post-accreditation that demonstrably promote patient safety and quality of care was perceived as more difficult. When planning for accreditation, institutions need to incorporate strategies to ensure that improvements to care continue beyond the accreditation period.

‘Are we on the same wavelength?’ International nurses and the process of confronting and adjusting to clinical communication in Australia

2017 ◽  
Vol 13 (3) ◽  
pp. 263-274 ◽  
Author(s):  
Tonia Crawford ◽  
Peter Roger ◽  
Sally Candlin
Keyword(s):  
Communication Skills ◽  
Thematic Analysis ◽  
Care Setting ◽  
Linguistically Diverse ◽  
The Other ◽  
Culturally And Linguistically Diverse ◽  
Central Theme ◽  
Structured Interviews ◽  
Clinical Communication ◽  
Professional Experiences

Effective communication skills are important in the health care setting in order to develop rapport and trust with patients, provide reassurance, assess patients effectively and provide education in a way that patients easily understand (Candlin and Candlin, 2003). However with many nurses from culturally and linguistically diverse (CALD) backgrounds being recruited to fill the workforce shortfall in Australia, communication across cultures with the potential for miscommunication and ensuing risks to patient safety has gained increasing focus in recent years (Shakya and Horsefall, 2000; Chiang and Crickmore, 2009). This paper reports on the first phase of a study that examines intercultural nurse patient communication from the perspective of four Registered Nurses from CALD backgrounds working in Australia. Five interrelating themes that were derived from thematic analysis of semi-structured interviews are discussed. The central theme of ‘adjustment’ was identified as fundamental to the experiences of the RNs and this theme interrelated with each of the other themes that emerged: professional experiences with communication, ways of showing respect, displaying empathy, and vulnerability.

Adverse Events Reporting System as Experienced by Critical-Care Nurses in KwaZulu-Natal, South Africa

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Thusile Mabel Gqaleni ◽  
Busisiwe Rosemary Bhengu
Keyword(s):  
South Africa ◽  
Critical Care ◽  
Adverse Events ◽  
Patient Care ◽  
Family Involvement ◽  
Reporting System ◽  
Legal Framework ◽  
Critical Care Nurses ◽  
Kwazulu Natal ◽  
Life Threatening

Critically ill patients admitted to critical-care units (CCUs) might have life-threatening or potentially life-threatening problems. Adverse events (AEs) occur frequently in CCUs, resulting in compromised quality of patient care. This study explores the experiences of critical-care nurses (CCNs) in relation to how the reported AEs were analysed and handled in CCUs. The study was conducted in the CCUs of five purposively selected hospitals in KwaZulu-Natal, South Africa. A descriptive qualitative design was used to obtain data through in-depth interviews from a purposive sample of five unit managers working in the CCUs to provide a deeper meaning of their experiences. This study was a part of a bigger study using a mixed-methods approach. The recorded qualitative data were analysed using Tesch’s content analysis. The main categories of information that emerged during the data analysis were (i) the existence of an AE reporting system, (ii) the occurrence of AEs, (iii) the promotion of and barriers to AE reporting, and (iv) the handling of AEs. The findings demonstrated that there were major gaps that affected the maximum utilisation of the reporting system. In addition, even though the system existed in other institutions, it was not utilised at all, hence affecting quality patient care. The following are recommended: (1) a non-punitive and non-confrontational system should be promoted, and (2) an organisational culture should be encouraged where support structures are formed within institutions, which consist of a legal framework, patient and family involvement, effective AE feedback, and education and training of staff.

Acceptance of the HPV Vaccine in a Multiethnic Sample of Latinx Mothers

2021 ◽  
Vol 31 (3) ◽  
pp. 472-483
Author(s):  
Ana Cristina Lindsay ◽  
Madelyne J. Valdez ◽  
Denisse Delgado ◽  
Emily Restrepo ◽  
Yessica M. Guzmán ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Thematic Analysis ◽  
Hpv Vaccine ◽  
Female Adolescents ◽  
Future Research ◽  
Care Providers ◽  
Foreign Born ◽  
Structured Interviews ◽  
Direct Benefits ◽  
Multiethnic Sample

This descriptive qualitative study explored Latinx mothers’ acceptance of the human papillomavirus (HPV) vaccine for their adolescent children. Data were collected through individual, semi-structured interviews and analyzed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Twenty-two ( n = 22), mostly foreign-born, Latinx mothers of male and female adolescents participated in the study. Three main themes and nine subthemes emerged from the analyses. Findings identified the need for increased efforts to raise awareness and knowledge among Latinx mothers of the direct benefits of the HPV vaccine for sons, including stressing prevention of HPV-associated cancers in males. Findings also underscore the need for improved health care providers’ communication and recommendation of the HPV vaccine for Latinx adolescent males. Future research should intervene upon the study’s findings to address barriers that remain and affect Latinx mothers’ acceptance and uptake of the HPV vaccine for their children, in particular their sons.

scholarly journals Staying Home, Staying Alive: Campus Food Pantry Student Clients’ Experiences During the COVID-19 Pandemic

2021 ◽  
pp. 193672442110356
Author(s):  
Elmira Jangjou
Keyword(s):  
Coping Strategies ◽  
Thematic Analysis ◽  
Future Research ◽  
Postsecondary Students ◽  
Structured Interviews ◽  
Short Term ◽  
Income Loss ◽  
Food Pantry ◽  
Global Pandemic ◽  
Seeking Help

In response to students’ food insecurity, a number of colleges and universities have taken action and established campus food pantries as part of their intervention plans. However, many of these pantries ceased operation due to COVID-19 campus shutdowns. The purpose of this study is to illustrate the short-term impacts of the COVID-19 pandemic on postsecondary students, who use a university-provided food pantry. Drawing from semi-structured interviews with 12 participants, the thematic analysis explored the initial coping strategies these students used to endure the pandemic. Findings revealed that many students experienced the immediate effects of the pandemic in the form of income loss, self-isolation, anxiety, and appetite change. Although the pandemic interrupted these students’ journeys to continue their studies and become independent in various ways, the affected students implemented various coping strategies, including seeking help from family or friends, using available resources, cooking at home, and even trying to save money. However, considering that the targeted population in this study was already at risk because of their basic needs insecurity, these postsecondary students require extra attention from their higher education institutions in the case of emergencies, such as a global pandemic. In addition to its timely and relevant findings, this study provides important avenues for future research and intervention efforts.

scholarly journals Physician Workflow in Two Distinctive Emergency Departments: An Observational Study

2021 ◽  
Vol 12 (01) ◽  
pp. 141-152
Author(s):  
Vimla L. Patel ◽  
Courtney A. Denton ◽  
Hiral C. Soni ◽  
Thomas G. Kannampallil ◽  
Stephen J. Traub ◽  
...  
Keyword(s):  
Patient Care ◽  
Emergency Departments ◽  
Direct Patient Care ◽  
Team Communication ◽  
Delivery Of Care ◽  
Physician Practices ◽  
Clinical Observations ◽  
Workflow Pattern ◽  
Open Coding ◽  
Temporal Events

Abstract Objectives We characterize physician workflow in two distinctive emergency departments (ED). Physician practices mediated by electronic health records (EHR) are explored within the context of organizational complexity for the delivery of care. Methods Two urban clinical sites, including an academic teaching ED, were selected. Fourteen physicians were recruited. Overall, 62 hours of direct clinical observations were conducted characterizing clinical activities (EHR use, team communication, and patient care). Data were analyzed using qualitative open-coding techniques and descriptive statistics. Timeline belts were used to represent temporal events. Results At site 1, physicians, engaged in more team communication, followed by direct patient care. Although physicians spent 61% of their clinical time at workstations, only 25% was spent on the EHR, primarily for clinical documentation and review. Site 2 physicians engaged primarily in direct patient care spending 52% of their time at a workstation, and 31% dedicated to EHRs, focused on chart review. At site 1, physicians showed nonlinear complex workflow patterns with a greater frequency of multitasking and interruptions, resulting in workflow fragmentation. In comparison, at site 2, a less complex environment with a unique patient assignment system, resulting in a more linear workflow pattern. Conclusion The nature of the clinical practice and EHR-mediated workflow reflects the ED work practices. Physicians in more complex organizations may be less efficient because of the fragmented workflow. However, these effects can be mitigated by effort distribution through team communication, which affords inherent safety checks.

scholarly journals Experiences of New Zealand Haemodialysis Patients in Relation to Food and Nutrition Management: A Qualitative Study

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2299
Author(s):  
Rachael M. McLean ◽  
Zhengxiu Xie ◽  
Vicky Nelson ◽  
Vili Nosa ◽  
Hla Thein ◽  
...  
Keyword(s):  
New Zealand ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Extended Family ◽  
Culturally Appropriate ◽  
Structured Interviews ◽  
Nutrition Management ◽  
Healthcare Needs ◽  
Food And Nutrition ◽  
Major Disruption

People receiving haemodialysis have considerable and complex dietary and healthcare needs, including co-morbidities. A recent New Zealand study has shown that few patients on haemodialysis are able to meet nutritional requirements for haemodialysis. This study aims to describe the perspectives and experiences of dietary management among patients on haemodialysis in New Zealand. This exploratory qualitative study used in-depth semi-structured interviews. Purposive sampling was used to recruit participants from different ethnic groups. Forty interviews were conducted, audio-recorded and transcribed verbatim. An inductive approach was taken using thematic analysis. Forty participants were interviewed. Participants spoke of major disruption to their lives as a result of their chronic kidney disease and being on haemodialysis, including loss of employment, financial challenges, loss of independence, social isolation and increased reliance on extended family. Most had received adequate dietary information, although some felt that more culturally appropriate support would have enabled a healthier diet. These findings show that further support to make the recommended dietary changes while on haemodialysis should focus on socio-cultural factors, in addition to the information already provided.

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