Interprofessional Team’s Perception of Care Delivery After Implementation of a Pediatric Pain and Sedation Protocol

2017 ◽  
Vol 37 (3) ◽  
pp. 66-76 ◽  
Author(s):  
Sandra L. Staveski ◽  
May Wu ◽  
Tiffany M. Tesoro ◽  
Stephen J. Roth ◽  
Michael J. Cisco

BACKGROUNDPain and agitation are common experiences of patients in pediatric cardiac intensive care units. Variability in assessments by health care providers, communication, and treatment of pain and agitation creates challenges in management of pain and sedation.OBJECTIVESTo develop guidelines for assessment and treatment of pain, agitation, and delirium in the pediatric cardiac intensive unit in an academic children’s hospital and to document the effects of implementation of the guidelines on the interprofessional team’s perception of care delivery and team function.METHODSBefore and after implementation of the guidelines, interprofessional team members were surveyed about the members’ perception of analgesia, sedation, and delirium managementRESULTSMembers of the interprofessional team felt more comfortable with pain and sedation management after implementation of the guidelines. Team members reported improvements in team communication on patients’ comfort. Members thought that important information was less likely to be lost during transfer of care. They also noted that the team carried out comfort management plans and used pharmacological and nonpharmacological therapies better after implementation of the guidelines than they did before implementation.CONCLUSIONSGuidelines for pain and sedation management were associated with perceived improvements in team function and patient care by members of the interprofessional team.

2017 ◽  
Vol 25 (6) ◽  
pp. 618-626 ◽  
Author(s):  
Marie Krousel-Wood ◽  
Allison B McCoy ◽  
Chad Ahia ◽  
Elizabeth W Holt ◽  
Donnalee N Trapani ◽  
...  

Abstract Objective We assessed changes in the percentage of providers with positive perceptions of electronic health record (EHR) benefit before and after transition from a local basic to a commercial comprehensive EHR. Methods Changes in the percentage of providers with positive perceptions of EHR benefit were captured via a survey of academic health care providers before (baseline) and at 6–12 months (short term) and 12–24 months (long term) after the transition. We analyzed 32 items for the overall group and by practice setting, provider age, and specialty using separate multivariable-adjusted random effects logistic regression models. Results A total of 223 providers completed all 3 surveys (30% response rate): 85.6% had outpatient practices, 56.5% were >45 years old, and 23.8% were primary care providers. The percentage of providers with positive perceptions significantly increased from baseline to long-term follow-up for patient communication, hospital transitions – access to clinical information, preventive care delivery, preventive care prompt, preventive lab prompt, satisfaction with system reliability, and sharing medical information (P < .05 for each). The percentage of providers with positive perceptions significantly decreased over time for overall satisfaction, productivity, better patient care, clinical decision quality, easy access to patient information, monitoring patients, more time for patients, coordination of care, computer access, adequate resources, and satisfaction with ease of use (P < 0.05 for each). Results varied by subgroup. Conclusion After a transition to a commercial comprehensive EHR, items with significant increases and significant decreases in the percentage of providers with positive perceptions of EHR benefit were identified, overall and by subgroup.


2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Kateryna Aksenchuk ◽  
Jasna K Schwind ◽  
Sherry Espin ◽  
Beth McCay ◽  
Jacqui Gingras

Objectives: Interprofessional whole-person care has been depicted as being able to enhance patient health outcomes, increase health care provider satisfaction with care delivery, lower health care spending and decrease wait times for receiving care. Limited research has been conducted into exploring patients’ experiences of being recipients of this type of care. The objective of this oral presentation is to disseminate findings of a Master of Nursing study through patients’ stories of experience receiving care on aunit where inter professional care is practiced.Methods: Three participants underwent a two step data collection process: a one hour semi-structured interview and a 30 minute symbolic image artistic exercise, as adapted from Schwind’s Narrative Reflective Process. Participants were invited to describe how they experienced receivingcare from an interprofessional team and whether or not they believed whole-person care was delivered to them. Collected data are being analyzed using Clandinin and Connelly’s Narrative Inquiry approach of three dimensionalspace, temporality, sociality and place.Results: The emerging results suggest that participants express satisfaction with the care they received from the interprofessional team on their unit. Their stories indicate that strong interprofessional team-work can contribute to patient satisfaction in care received. For these teams to be successful, from the patients’ point of view, there needs to be: better communication between care providers, greater involvement of the patient in decision making, proper identification of who comprises the teams, andconsistency in team composition.Conclusion: By acknowledging experiences and feelings ofpatients who have received care from an interprofessional team, there is potential to increase sustainability of these teams. The data generated through this study can potentially help health care providers, who are members of interprofessional teams, to deliver more effective, comprehensive whole-personcare within health care institutions.


2013 ◽  
Vol 22 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Debora Downey ◽  
Mary Beth Happ

Abstract Hospitalized patients across the age continuum often present with complex communication needs (CCN) due to motor, sensory, cognitive, and linguistic barriers they may experience during their admission. Although hospitals recognize the need to enhance communication to improve quality and safety for all patients, the emphasis has been primarily on improving ”care coordination” amongst the health care providers the patient encounters across all points of admission. Most hospitals have yet to focus on improving the patient-provider communication experience, especially for patients with CCN. However, this population no longer can be ignored, as new standards mandate efforts to improve communication for patients with CCN. Nurses, as the team members responsible for continuous care during hospital stays, and speech-language pathologists, as communication disorders specialists, are positioned distinctively to facilitate patient communication and prevent miscommunications between patients and care providers. This article highlights the need to enhance the patient-provider communication experience for patients with CCN. We review the state of nurse training for patients with CCN, discuss the role speech-language pathologists can play in developing and implementing nurse training protocols, and outline basic elements nurse training modules should include.


2004 ◽  
Vol 16 (1) ◽  
pp. 45-49 ◽  
Author(s):  
P.Y. Lee ◽  
E.M. Khoo

70 patients presented with acute asthma exacerbation requiring nebulised bronchodilator treatment at the emergency department of a teaching hospital in Kuala Lumpur, Malaysia, were interviewed over a two-week period in July 2001. The results showed that 45 (64%) patients had not been educated on the nature of asthma; 30 (43%) had not been advised on preventive measures or avoidance of triggers; 54 (77%) were not advised about the medications used and their side effects; 42 (60%) patients did not know the difference between reliever and preventive medications; 37 (53%) were unable to recognize features of worsening asthma and 68 (97%) were not told about the danger of non-prescribed self-medication or traditional medications. Only six (9%) patients were using peak flow meters and were taught self-management plans. The multiple regression results suggest that patients who were followed up at teaching hospital based clinics were better educated on asthma. In conclusion, asthmatic patients are still not educated well about their disease. Health care providers need to put more emphasis on asthma education so that the number of emergency room visits can be reduced. Asia Pac J Public Health 2004; 16(1): 45-49.


1997 ◽  
Vol 23 (1) ◽  
pp. 45-68 ◽  
Author(s):  
Alexandra K. Glazier

Discovering the genetic basis of a particular disease is not only of great interest to the medical community; private health insurers are also anxiously awaiting the results of genetic linkage studies. Apart from the scientific value of DNA studies, the results of genetic linkage research are relevant to health care delivery in two principal ways. First, identifying the genetic origin of a disease may allow doctors to detect the disease earlier. If doctors know that an individual is genetically predisposed to a particular disease, then health care providers can increase screening efforts and watch for early symptoms. Second, if an individual has a genetic predisposition to a particular disease, health care providers may employ preventive or “prophylactic" measures to reduce or eliminate the risk of developing the disease or condition to which the individual is genetically predisposed. Genetic linkage studies will soon allow more individuals to learn of their own genetic predispositions to certain diseases. Currently genetic predisposition tests (both pedigrees of family history and DNA analysis) can indicate that an individual is at high risk for developing a disease.


1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.


2021 ◽  
Vol 8 ◽  
pp. 237437352110180
Author(s):  
Robin E. McAtee ◽  
Laura Spradley ◽  
Leah Tobey ◽  
Whitney Thomasson ◽  
Gohar Azhar ◽  
...  

Millions of Americans live with dementia. Caregivers of this population provide countless hours of multifaceted, complex care that frequently cause unrelenting stress which can result in immense burden. However, it is not fully understood what efforts can be made to reduce the stress among caregivers of persons with dementia (PWD). Therefore, the aim of this pretest–posttest designed study was to evaluate changes in caregiver burden after providing an educational intervention to those caring for PWD in Arkansas. Forty-one participants completed the Zarit Caregiver Burden Scale before and after attending a 4-hour dementia-focused caregiving workshop. The analysis of the means, standard deviations, and paired t tests showed that there was an increase in the confidence and competence in caring for PWD 30 to 45 days after attending the workshop. Health care providers need to understand both the vital role caregivers provide in managing a PWD and the importance of the caregiver receiving education about their role as a caregiver. Utilizing caregiver educational programs is a first step.


2014 ◽  
Vol 28 (6) ◽  
pp. 754-776 ◽  
Author(s):  
Nancy J. Yanchus ◽  
Ryan Derickson ◽  
Scott C. Moore ◽  
Daniele Bologna ◽  
Katerine Osatuke

Purpose – The purpose of this paper is to explore employee perceptions of communication in psychologically safe and unsafe clinical care environments. Design/methodology/approach – Clinical providers at the USA Veterans Health Administration were interviewed as part of planning organizational interventions. They discussed strengths, weaknesses, and desired changes in their workplaces. A subset of respondents also discussed workplace psychological safety (i.e. employee perceptions of being able to speak up or report errors without retaliation or ostracism – Edmondson, 1999). Two trained coders analysed the interview data using a grounded theory-based method. They excerpted passages that discussed job-related communication and summarized specific themes. Subsequent analyses compared frequencies of themes across workgroups defined as having psychologically safe vs unsafe climate based upon an independently administered employee survey. Findings – Perceptions of work-related communication differed across clinical provider groups with high vs low psychological safety. The differences in frequencies of communication-related themes across the compared groups matched the expected pattern of problem-laden communication characterizing psychologically unsafe workplaces. Originality/value – Previous research implied the existence of a connection between communication and psychological safety whereas this study offers substantive evidence of it. The paper summarized the differences in perceptions of communication in high vs low psychological safety environments drawing from qualitative data that reflected clinical providers’ direct experience on the job. The paper also illustrated the conclusions with multiple specific examples. The findings are informative to health care providers seeking to improve communication within care delivery teams.


2021 ◽  
Vol 8 ◽  
pp. 237437352198924
Author(s):  
Jassem Almualem ◽  
Amal Darwish ◽  
Ahmed AlFaraj

Patients with cardiac conditions may suffer from anxiety related to prognosis and further rehabilitation. Anxiety could be exacerbated by different factors including miscommunication, which could be attributed to the linguistic barrier, that exists among health care providers. At Saud Al-Babtain Cardiac Center (SBCC), nurses who are non-native Arabic speakers could have difficulty communicating disease-related information at different stages of nursing care. Is it possible to identify the language barrier as a source of anxiety for admitted patients with cardiac diseases? In this cross-sectional, descriptive study, 50 patients were included following the diagnosis of cardiac disease and post-cardiac surgery. A questionnaire that measures anxiety level showed that patients who were handled by Arabic-speaking nurses reported less collective mean for the anxiety domain statements of (20.08) versus those who were handled by Non-Arabic-speaking nurses (28.55, P value = .041). Our finding indicates that anxiety levels increased when there was a language barrier between nurses and patients, which could affect the quality of care delivery at SBCC.


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