scholarly journals Self-rated worry in acute care telephone triage: a mixed-methods study

2018 ◽  
Vol 68 (668) ◽  
pp. e197-e203 ◽  
Author(s):  
Hejdi Gamst-Jensen ◽  
Linda Huibers ◽  
Kristoffer Pedersen ◽  
Erika F Christensen ◽  
Annette K Ersbøll ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Acute Care ◽  
Clinical Decision Making ◽  
Mixed Methods Study ◽  
Symptom Duration ◽  
Telephone Triage ◽  
Out Of Hours ◽  
Thematic Content ◽  
Reason For Encounter ◽  
Telephone Calls

BackgroundTelephone triage is used to assess acute illness or injury. Clinical decision making is often assisted by triage tools that lack callers’ perspectives. This study analysed callers’ perception of urgency, defined as degree of worry in acute care telephone calls.AimTo explore the caller’s ability to quantify their degree of worry, the association between degree of worry and variables related to the caller, the effect of degree of worry on triage outcome, and the thematic content of the caller’s worry.Design and settingA mixed-methods study with simultaneous convergent design combining descriptive statistics and thematic analysis of 180 calls to a Danish out-of-hours service.MethodThe following quantitative data were measured: age of caller, sex, reason for encounter, symptom duration, triage outcome, and degree of worry (rated from 1 = minimally worried to 5 = extremely worried). Qualitative data consisted of audio-recorded telephone calls.ResultsMost callers (170 out of 180) were able to scale their worry when contacting the out-of-hours service (median = 3, interquartile range = 2–4, mean = 2.76). Degree of worry was associated with female sex (odds ratio [OR] 1.98, 95% CI = 1.13 to 3.45) and symptom duration (>24 hours: OR 2.01, 95% CI = 1.13 to 3.45) (reference <5 hours), but not with age or reason for encounter. A high degree of worry significantly increased the chance of being triaged to a face-to-face consultation. The thematic content of worry varied from emotions of feeling bothered to feeling distressed. Callers provided more contextual information when asked about their degree of worry.ConclusionCallers were able to rate their degree of worry. The degree of worry scale is feasible for larger-scale studies if incorporating a patient-centred approach in out-of-hours telephone triage.

17 Key information summary (KIS) generation for people who died in scotland in 2017: a mixed methods study

2018 ◽  
Vol 8 (3) ◽  
pp. 366.1-366
Author(s):  
Anne M Finucane ◽  
Deborah Davydaitis ◽  
Emma Carduff ◽  
Zoe Horseman ◽  
Paul Baughan ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Care Plan ◽  
List Type ◽  
Electronic Patient Records ◽  
Essential Information ◽  
Out Of Hours ◽  
Essential Components ◽  
Out Of Hours Care

IntroductionThe percentage of people with a key information summary (KIS) or an anticipatory care plan (ACP) at the time of death can act as an indicator of access to palliative care. Key information summaries (KIS) introduced throughout Scotland in 2013, are shared electronic patient records which contain essential information relevant to a patient’s care including palliative care. There is now a need to examine current levels of KIS generation and ACP documentation in the last months of life to assess progress and review barriers and facilitators to sharing patient information across settings and to inform out-of-hours care.AimsTo estimate the extent and timing of KIS and ACP generation for people who die with an advanced progressive condition and to compare with our previous study (Tapsfield et al. 2016).To explore GP experiences of commencing and updating a KIS; and their perspectives on what works well and what can be improved in supporting this process.MethodsA mixed methods study consisting of a retrospective review of the electronic records of all patients who died in 16 Scottish general practices in 2017 and semi-structured interviews with 16 GPs.ResultsQuantitative and qualitative data collection is in progress.ConclusionFindings will describe current levels of KIS and ACP documentation for people who die in Scotland. We will synthesize GP experiences of KIS use and describe the essential components of an ACP that need to be documented to enable good palliative care across settings including emergency and out-of-hours care.Reference. Tapsfield J, Hall C, Lunan C, McCutheon H, McLoughlin P, Rhee J, Rus A, Spiller J, Finucane AM, Murray SA. Many people in Scotland now benefit from anticipatory care before they die: An after death analysis and interviews with general practitioners. BMJ Supportive and Palliative Care2016. doi:10.1136/bmjspcare-2015-001014

scholarly journals Infection control link nurse programs in Dutch acute care hospitals; a mixed-methods study

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Mireille Dekker ◽  
Rosa van Mansfeld ◽  
Christina Vandenbroucke-Grauls ◽  
Martine de Bruijne ◽  
Irene Jongerden
Keyword(s):  
Mixed Methods ◽  
Infection Control ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Mixed Methods Study

scholarly journals Clinical decision-making at the end of life: a mixed-methods study

2018 ◽  
Vol 10 (3) ◽  
pp. e26-e26 ◽  
Author(s):  
Paul Taylor ◽  
Miriam J Johnson ◽  
Dawn Wendy Dowding
Keyword(s):  
Heart Failure ◽  
Decision Making ◽  
Mixed Methods ◽  
End Of Life ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Study Groups ◽  
Mixed Methods Study ◽  
Semistructured Interview ◽  
The North

ObjectivesTo improve the ability of clinical staff to recognise end of life in hospital inpatients dying as a result of cancer and heart failure, and to generate new hypotheses for further research.MethodsThis mixed-methods study used decision theory as a theoretical basis. It involved a parallel databases-convergent design, incorporating findings from previously published research, with equal priority to study groups and synthesis by triangulation. The individual arms were (1) a retrospective cohort study of 102 patients with cancer and 81 patients with heart failure in an acute trust in the North of England, and(2) a semistructured interview study of 19 healthcare professionals caring for the same patient groups.ResultsThe synthesis of findings demonstrated areas of agreement, partial agreement, silence and dissonance when comparing the cohort findings with the interview findings. Trajectories of change are identified as associated with poor prognosis in both approaches, but based on different parameters. Management of patients has a significant impact on decision-making. The decision process requires repeated, iterative assessments and may benefit from a multidisciplinary approach. Uncertainty is a defining characteristic of the overall process, and objective parameters only have a limited role in predicting end of life.ConclusionsThe role of uncertainty is important as a trigger for discussions and a defined stage in a patient’s illness journey. This is consistent with current approaches to recognising irreversible deterioration in those with serious illness. This study contributes ongoing evidence that these concepts are vital for decision-making.

The Environmental Services Perspective on Hospital Room Design: A Mixed-Methods Approach

2017 ◽  
Vol 6 (1) ◽  
pp. 104-108 ◽  
Author(s):  
Emily S. Patterson ◽  
Elizabeth Sanders ◽  
Carolyn M. Sommerich ◽  
Kevin D. Evans ◽  
Steven A. Lavender ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Patient Care ◽  
Acute Care ◽  
Mixed Methods Study ◽  
Environmental Services ◽  
Healthcare Staff ◽  
Design Features ◽  
Mixed Methods Approach ◽  
Room Size ◽  
Room Design

Our aim is to enhance the safety and efficiency of all healthcare staff by designing patient rooms that meet the physical and cognitive needs of those providing direct and indirect patient care in hospital settings. A mixed-methods study was employed, where findings were compiled from twenty-six environmental services personnel across study activities. The insights were grouped into six categories of challenges with the design of hospital rooms in acute care settings: room cleaning, bathroom, room size, furniture, communication, and a miscellaneous ‘other’ category. There are design implications for storage, room design features, locations of room items, and fabrics and finishes.

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