COMMUNICATION OF PROFESSIONAL CAREGIVERS IN ESTABLISHING INTERPROFESSIONAL COLLABORATION AT MEURAXA HOSPITAL, BANDA ACEH

Background: Interprofessional collaboration for patient care is integrated cooperation between health workers in ensuring optimally consecutive patient care. Interprofessional decisions should be made in two ways between professional caregivers.Aims: This study aimed to analyze communication between professional caregivers in establishing interprofessional collaboration at Meuraxa District General Hospital in Banda Aceh.Method: This study was qualitative research and used a phenomenological approach. In-depth interviews and FGD were conducted with professional caregivers consisting of doctors in charge, nurses, pharmacists, and dietitians. All of the in-depth interviews and FGD were recorded and transcribed. Data obtained were analyzed thematically.Results: Communication between professional caregivers in establishing interprofessional collaboration at the hospital had not been well-performed. Overall, they had not optimally utilized integrated patient progress records as they focused on taking care of their patients individually. They also lacked literacy about the information in the records. Inadequate time in serving patients and the insufficient number of human resources were presumed to hamper interprofessional communication.Conclusion: Promoting interprofessional collaboration and effective communication regularly is required by the hospital management. They also need to evaluate the sufficiency of human resources, especially pharmacist positions. Besides, they can formulate supervision and evaluation systems of interprofessional communication between professional caregivers. Keywords : communication, integrated patient progress record, interprofessional collaboration, professional caregivers

Comparison of Charge Nurses’ and Registered Nurses’ Perceptions of Management Functions in the Implementation of Supervision in Hospital

Introduction: Different perceptions in the supervision process, part of the management functions of nurse manager, are at risk and have a bad impact, such as conflicts that will result in lack of motivation, communication barrier, and decreased performance and quality of services in the hospital. Purpose: The purpose of the study was to compare the perception of the head of the room with the implementing nurse about the role and function of management in the implementation of supervision. Methods: This quantitative study was conducted on a population of 515 nurses, and 81 nurses were used as a sample (71 nurses and 7 room heads) which were selected by accidental sampling. The research tool is in the form of a questionnaire containing management functions in supervision. Data were analyzed using independent t-test. Results: The results of this research did not show a significant difference between charge nurses’ and registered nurses’ perceptions of the management function in supervision, as indicated by the p-value> 0.025 (95% CI), p-value = 0.990 (planning), p-value = 0.957 (organizing), p-value=0.962 (staffing), p-value=0.508 (directing), Conclusion: With actuating aspect that obtained p-value = 0.977 and controlling aspect that obtained p-value = 0.790, the conclusion of this research is there was no significant difference between charge nurses’ and registered nurses’ perceptions of management functions in supervision.

Mental Health Status and Its Influencing Factors: The Case of Nurses Working in COVID-19 Hospitals in South Korea

The mental health of nurses participating in patient care is under threat amid the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to identify the mental health status (depression, anxiety, and stress) and its influencing factors on nurses who provided patient care at a specialized hospital for COVID-19 in South Korea. Of the 180 nurses who participated in this study, 30.6% had moderate or higher levels of depression, 41% had moderate or higher anxiety levels, and 19.4% had moderate or higher stress levels. In this study, stigma influenced nurses’ mental health, such that the higher the stigma, the higher the nurses’ depression, anxiety, and stress. Depression was higher in female nurses than in male nurses, and stress was higher in charge nurses than nurses in other job positions. Therefore, a management program should be designed to improve the mental health of nurses during the current pandemic. In particular, a solution to reduce stigma is required, and the mental health of female nurses and nurses in leadership roles requires special attention.

Audit on resuscitation equipment in Carseview Centre (NHS Tayside)

AimsPsychiatric hospitals are well equipped to manage patients with complex psychiatric needs, however due to their community setting when a rare medical emergency occurs it is not unusual for a small delay whilst staff search for equipment on the ward or even go to other wards for equipment. The aim of this audit is to ensure that our psychiatric wards in Carseview Centre are well equipped to respond to patients becoming medically unwell and put our nurses and doctors in a position to safely stabilise the patient until furthur help arrives.MethodWe collected data from 3 inpatient adult wards, 1 intensive psychiatric care unit and 1 learning disability unit and compared their resuscitation trolley equipment with local NHS Tayside Emergency Equipment Protocol in January 2020. Following data collection we fed back to the wards about our results and discussions were held between doctors, charge nurses, pharmacists and resuscitation officers to determine whether missing equipment were neccesary in the community setting and to see if there were updates that required for our local protocol to better reflect current practices as it had not been reviewed since 2012. Following multiple meetings we amended our local protocol to better reflect what was . A list of recommendations was also made to improve patient safety.We then collected data again in January 2021ResultFolloing our first data collection we found that the resuscitation trolleys tended to not have ligature packs and masks were generally not by the oxygen cylinders. Hypoglycaemic dextro-tablets were also not readily available. The Learning disability units also did not have an emergency resuscitation trolley.Following our discussions and amendment of the protocol this was finalised in November 2020 and was dissemindated towards the wards and we waited 2 months for the changes to take effects and recollected our data. There continued to be equipment that was incomplete/missing on each individual ward, but none that were consistent throughout the whole hospital site. All the recommendations that were made for the 1st data collection had been done.ConclusionOverall we felt that the emergency trolleys were better equipped in line with the updated protocol compared to the previous audit cycle. The overall pattern of missing equipment was inconsistent and the recommendation was for staff to copmlete checks to address missing/incomplete items when found. Our local protocol also recommends that all ward should stock ‘additional items’ (nebuliser masks and non-rebreather masks), which majority had however were difficult to locate, which could delay patient care.We will continue to repeat data collection cycles and feedback to our wards to ensure patient safety is not compromised.

Abstract P854: Lean A3 Project in a Primary Stroke Center Results in Improved Dysphagia Screening Compliance for Stroke

Introduction: Dysphagia is a common comorbidity after stroke linked to increased morbidity and mortality. Evidence-based guidelines recommend a bedside dysphagia screen before oral intake to reduce the risk of aspiration pneumonia in stroke patients. Prior studies have reviewed barriers to dysphagia screens being completed or documented timely on stroke patients before giving oral intake. Through Lean A3 process, we aimed to improve overall nursing documentation, including dysphagia screen, for stroke patients in the Emergency Department (ED) at an established Primary Stroke Center. Methods: The ED Charge Nurses and the Stroke Coordinator began an A3 project in May 2019 which focused on ED nurse documentation for stroke patients. Data included was 7 months prior to A3 implementation and 8 months post-implementation using Get With The Guidelines quality “Dysphagia Screen” measure. Lean A3 process involved changes to the computer system and re-education of nursing staff in July 2019 by the charge nurses and Stroke Coordinator. The post-A3 measurement period was between August 2019 and March 2020. Chi square tests were used to assess proportion differences in completed dysphagia screen and proportion of meeting or exceeding goal before and after the A3. Results: Overall compliance of patients screened for dysphagia was 87.3% (n = 379/434). After the A3 project, compliance for dysphagia screening was significantly higher than prior to the A3 implementation ((91.9% (n = 228/248) vs. 81.2% (n = 151/186), OR = 2.64 [95%CI 1.47-4.75], p < 0.001). In addition, the 90% goal for dysphagia screen compliance was achieved only 1 month of 7 (14.3%) prior to A3, but was achieved in 6 months of 8 post-A3 (75%), p = 0.04. Conclusion: In conclusion, we found that dysphagia screening documentation by ED nurses improved due to the Lean A3 process improvement project conducted in the ED.

Personnel Scheduling Problem under Hierarchical Management Based on Intelligent Algorithm

This paper studies a special scheduling problem under hierarchical management in nurse staff. This is a more complex rostering problem than traditional nurse scheduling. The first is that the rostering requirements of charge nurses and general nurses are different under hierarchical management. The second is that nurses are preferable for relative fair rather than absolute fair under hierarchical management. The model aims at allocating the required workload to meet the operational requirements, weekend rostering preferences, and relative fairness preferences. Two hybrid heuristic algorithms based on multiobjective grey wolf optimizer (MOGWO) and three corresponding single heuristic algorithms are employed to solve this problem. The experimental results based on real cases from the Third People’s Hospital, Panzhihua, China, show that MOGWO does not as good as it does on other engineering optimization. However, the hybrid algorithms based on MOGWO are better than corresponding single algorithms on generational distance (GD) and spacing (SP) of Pareto solutions. Furthermore, for relative fair rostering objective, NSGAII-MOGWO has more power to find the optimal solution in the dimension of relative fairness.

Disaster preparedness for charge nurses: A program evaluation

Over the last 3 years at a large, midwestern, pediatric hospital, there have been near disaster events, a few of which required transfer or evacuation of patients. The responses from the inpatient units to these events have varied greatly and can be traced back to communication, knowledge, comfort level, and effectiveness of the charge nurses on the nursing units. A task force was formed to understand the variation in their disaster response procedures and to standardize disaster response procedures. Respondents included the bedside, clinical leadership, managers of patient services, emergency preparedness management, and senior leadership. This resulted in the creation of a tabletop simulation exercise for use by inpatient charge nurses within the institution. The results indicated that participants reported higher levels of self-reported knowledge, confidence, and effectiveness regarding the disaster preparedness on their units (p 0.001). The program was effective, with feedback from participants indicating the need for more frequent and/or department specific education.

New nurse graduates and rapidly changing clinical situations: the role of expert critical care nurse mentors

Objectives New nurse graduates may be prone to instances of failure to rescue. Mentoring programs may be an opportunity to assist them with clinical decision making in situations of patient decline. We explored the experiences of new nurse graduates and expert nurses after participation in a mentoring program. Methods In this exploratory-descriptive study, five seasoned nurses were paired with five new nurse graduates. After four months, the new nurse graduates were interviewed, and the expert nurses participated in a focus group. Results Themes emerged for the new nurse graduates: 1) importance of the charge nurse, 2) differences in practice areas, and 3) supportive healthcare teams. The focus group revealed three themes: 1) remembering what it was like, 2) desiring to help, and 3) having confidence in their preparation as mentors. Conclusions New nurse graduates relied on charge nurses for assistance. Therefore, it is imperative that charge nurses receive adequate support.