scholarly journals Paediatric Intensive Care Staff Experiences of Debriefing Post Critical Incident; a Qualitative Study of the Leeds ‘time Out’ Method

2020 ◽  
Author(s):  
Mark Winton ◽  
Sian Cooper ◽  
Gary Latchford

Abstract BackgroundHow intensive care teams respond to critical incidents is important for maintaining effective patient care, staff education and morale(1). We investigated Paediatric Intensive Care (PIC) staff experiences of participating in novel 20 minute group ‘time outs’ held after critical incidents.MethodA qualitative study using semi-structured interviews with staff attendees of ‘time outs’. Interviews transcribed and analysed using thematic analysis. Results shared with interviewees for participant validation. Ethical approval granted by the University of Leeds School of Medicine Research Ethics Committee (approval number SOMREC17-020).Results8 semi-structured interviews lasted on average 45 minutes each. Participant roles; 1 Consultant, 1 PIC grid trainee, ST3 Paediatrician, 1 Advanced Nurse Practitioner, 2 Band 6 Nurses and 2 Band 7 Nurses. Thematic analysis generated 1,060 initial codes, subsequently revised until a thematic map emerged, containing five main themes: 1. Context and culture in which critical incidents and ‘time outs’ are embedded, including hierarchy and local politics.2. Pragmatics of organising and evaluating ‘time outs’.3. Position of valued clinical psychologists, who were removed from the ‘time outs’.4. Reflections on coping and resilience, notably blame and fear.5. Process of attending a time out and its impact – both positive (clinical knowledge and the ability to cope) and negative (damaging if inappropriately run).ConclusionThe data contextualised the time outs within the complex PIC environment, with politics, communication challenges and hierarchies affecting how staff respond and how they are supported following critical incidents. Though practical challenges of time outs were noted, this intervention has potential to improve the understanding and well-being of PIC staff after critical incidents.

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2299
Author(s):  
Rachael M. McLean ◽  
Zhengxiu Xie ◽  
Vicky Nelson ◽  
Vili Nosa ◽  
Hla Thein ◽  
...  

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.


Author(s):  
Nooreddine Iskandar ◽  
Tatiana Rahbany ◽  
Ali Shokor

Abstract Background: Due to the common instability caused by political and security issues, Lebanese hospitals have experienced acts of terrorism multiple times. The most recent Beirut Explosion even forced several hospitals to cease operations for the first time in decades—but studies show the preparedness levels for such attacks in similar countries are low. Objective: The aim of this study is to explore the experience of Lebanese hospitals with terrorist attacks. Methods: This qualitative study used semi-structured interviews with various stakeholders to assess their experience with terrorist bombings. Data was analyzed using the thematic analysis method. Results: The researchers found that Lebanese hospitals vary greatly in their structures and procedures. Those differences are a function of 3 contextual factors: location, culture, and accreditation status. Hospitals found near ‘dangerous zones’ were more likely to be aware and to have better response to such events. A severe lack of communication, unity of command, and collaboration between stakeholders has made the process fragmented. Conclusion: The researchers recommend a larger role for the Ministry of Public Health (MOPH) in this process, and the creation of a platform where Lebanese organizations can share their experiences to improve preparedness and resilience of the Lebanese healthcare system in the face of terrorism.


2017 ◽  
Vol 176 (3) ◽  
pp. 423-427 ◽  
Author(s):  
Thomas Brick ◽  
◽  
Rachel S. Agbeko ◽  
Patrick Davies ◽  
Peter J. Davis ◽  
...  

2020 ◽  
pp. 175114371989278
Author(s):  
Zahra Salehi ◽  
Soodabeh Joolaee ◽  
Fatemeh Hajibabaee ◽  
Tahereh Najafi Ghezeljeh

Background Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide. Aim This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units. Methods This qualitative study was conducted in 2018–2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0). Findings Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint). Conclusion Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues.


2018 ◽  
Vol 13 (8) ◽  
pp. 184 ◽  
Author(s):  
Umar Altahtooh ◽  
Thamir Alaskar

Despite the importance of milestone as a key knowledge in project management, there has been lack of research to understand the relationship between milestones and decision-making. This paper presents a pragmatic research context that aims understanding the nature of milestones and their relationship with different decision-making structures and responsibilities across projects. Data were collected through 14 semi-structured interviews with project managers and analyzed using thematic analysis. The findings explore the concepts of project milestones among project managers in Saudi Arabia. The paper finds that there is a relationship between milestones and the impact on decision-making.


2007 ◽  
Vol 10 (4) ◽  
pp. 2156759X0701000
Author(s):  
Colette T. Dollarhide ◽  
Alexanderia T. Smith ◽  
Matthew E. Lemberger

The qualitative study in this article explores critical incidents that may facilitate the support a principal provides for a school counseling program. Through structured interviews, supportive principals are asked to reflect on their prior experiences with school counselors, their educational exposure to school counseling, and their recommendations for school counselors. Results suggest that by demonstrating effective leadership and systemic interactions, school counselors can foster relationships with principals that can help them expand their roles and their programs.


2018 ◽  
Vol 25 (13-14) ◽  
pp. 2464-2474 ◽  
Author(s):  
Marthe R Egberts ◽  
Rinie Geenen ◽  
Alette EE de Jong ◽  
Helma WC Hofland ◽  
Nancy EE Van Loey

A burn injury event and subsequent hospitalization are potentially distressing for children. To elucidate the child’s experience of pediatric burn injury, children’s reflections on the burn event and its aftermath were examined. Semi-structured interviews were conducted with eight children (12–17 years old). Using thematic analysis, interview transcripts were coded and codes were combined into overarching categories. Three categories were identified: vivid memories; the importance of parental support; psychosocial impact and coping. Implications for care are discussed in terms of assessing children’s appraisals, paying attention to the parent’s role, and preparing families for potential psychological barriers after discharge.


Dementia ◽  
2018 ◽  
Vol 18 (2) ◽  
pp. 776-784 ◽  
Author(s):  
Tanya Hobden ◽  
Mary Swallow ◽  
Charlotte Beer ◽  
Tom Dening

Swimming is a non-weight bearing form of exercise that can be enjoyable and promote physical fitness. This qualitative study investigated a local group established as part of a national dementia swimming initiative. Semi-structured interviews with people with dementia (N = 4), carers or companions (N = 4) and the organisers and facilitators of the group (N = 6) were analysed using thematic analysis. This revealed four main themes: (1) the pleasure of swimming and its benefits as a form of exercise and for building confidence and empowering participants, (2) the importance of insight and empathy in creating a safe and secure experience, (3) the impact of dementia and (4) how participants valued being part of a group ‘all in the same boat’. ‘Dementia friendly swimming’ appears to be a valuable form of exercise, but it requires considerable preparation and support to make it happen.


Author(s):  
Viviana Dávalos-Batallas ◽  
Vinita Mahtani-Chugani ◽  
Carla López-Núñez ◽  
Víctor Duque ◽  
Fatima Leon-Larios ◽  
...  

Background: The worldwide need for palliative care is high, especially in mid- income countries like Ecuador, where the percentage of patients receiving such care is very small due to the scarcity of infrastructure and specialized personnel and to the unequal distribution in the country. The objective of this study is to explore the knowledge, attitudes and expectations related to palliative care of the physicians in Ecuador. Methods: A qualitative study based on 28 semi-structured interviews, from March 2014 to November 2016, with physicians working in four cities in Ecuador recruited through the snowball technique. Thematic analysis was developed supported by the ATLAS.ti software. Results: Five core themes were identified: (1) training, (2) health policy, (3) professionals’ activities, (4) health services and (5) development of palliative care in Ecuador. Conclusions: Strategies are needed which intensify the training of medical professional in palliative care, as well as avail the human resources and materials for providing it.


2020 ◽  
pp. 107755872097258
Author(s):  
Deb Mitchell ◽  
Lisa O’Brien ◽  
Anne Bardoel ◽  
Terry Haines

This longitudinal qualitative study examines staff experience of disinvestment from a service they are accustomed to providing to their patients. It took place alongside a disinvestment trial that measured the impact of the removal of weekend allied health services from acute wards at two hospitals. Data were gathered from repeated interviews and focus groups with 450 health care staff. We developed a grounded theory, which explains changes in staff perceptions over time and the key modifying factors. Staff appeared to experience disinvestment as loss; a key difference to other operational changes. Early staff experiences of disinvestment were primarily negative, but evolved with time and change-management strategies such as the provision of data, clear and persistent communication approaches, and forums where the big picture context of the disinvestment was robustly discussed. These allowed the disinvestment trial to be successfully implemented at two health services, with high compliance with the research protocol.


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