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Labrague LJ. Nurses' adherence to patient safety protocols and its relationship with adverse patient events. J Nurs Scholarsh 2024; 56:282-290. [PMID: 37950503 DOI: 10.1111/jnu.12942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/12/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Ensuring patient safety is a critical component of healthcare delivery, and nurses play a vital role in adhering to patient safety protocols to prevent adverse events. However, studies linking nurses' adherence to these protocols with patient outcomes is scarce. This study has two-fold purposes: (1) to examine determinants of nurses' adherence to patient safety protocols, and (2) to investigate the relationship between nurses' adherence to patient safety protocols and adverse patient events. DESIGN A cross-sectional design. METHODS A total of 343 clinical nurses from five hospitals in the Philippines were included in this study. Two standardized scales were used to collect data, including the Patient Safety Adherence Scale and the Adverse Patient Events Scale. Data collection took place from April 2022 to August 2022. RESULTS Adherence to patient safety protocols was generally moderate to high (M = 4.483), while nurse-reported adverse events occurred at a lower frequency (M = 1.150). Lower adherence rates were identified in areas such as reporting safety errors (M = 3.950), conducting fall risk assessments (M = 4.299), and adhering to pressure ulcer prevention guidelines (M = 3.979). Patients' and their families' complaints (M = 2.129) and abuses (M = 1.475) were the most frequently reported adverse events. Increased adherence to safety protocols was associated with higher reporting of adverse patient events (β = 0.115, p < 0.001). CONCLUSION Higher adherence to patient safety protocols resulted in an increased reporting of adverse patient events. The factors identified that contributed to nurses' adherence to patient safety protocols can be utilized in the development of strategies aimed at improving compliance, especially in areas where adherence is currently low. CLINICAL RELEVANCE Healthcare organizations should prioritize efforts to enhance adherence to patient safety protocols, particularly in areas with lower compliance rates, through relevant trainings, resource provision, and support systems. Promoting a culture of open communication and reporting can significantly contribute to reducing adverse events and improving patient safety.
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Affiliation(s)
- Leodoro J Labrague
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, Illinois, USA
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Heydarikhayat N, Ghanbarzehi N, Sabagh K. Strategies to prevent medical errors by nursing interns: a qualitative content analysis. BMC Nurs 2024; 23:48. [PMID: 38233901 PMCID: PMC10792785 DOI: 10.1186/s12912-024-01726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Nursing interns often face the serious challenges and stress of clinical training. Identifying effective strategies in reducing medical errors can improve student performance and decrease patient risk and injury from errors. The purpose of this study was to identify strategies to prevent medical errors by nursing interns in Medical Universities in Sistan and Baluchistan, Southeast of Iran. METHODS This is a qualitative study using a content analysis approach. Purposive sampling was used. The study was conducted in 3 medical universities. Ten nursing interns participated in this study. Open-ended, semi-structured, and face-to-face, interviews were used to explore the experience of nursing interns about strategies to prevent medical errors during their internship. RESULTS Findings include 20 subcategories, 6 categories and one theme. The main theme is "strategies to prevent medical errors during internship". Six categories included "strategies to prevent medical errors during internship". These included "Professional acceptance and support", "Revision of the implementation of the educational curriculum", "Retraining courses for challenging skills", "Creating learning opportunities" "Professionalization", and "Facilities and requirements". CONCLUSIONS Preventing medical errors requires different strategies before and during nursing internship. Error prevention strategies include retraining and preparatory courses for challenging areas, evaluation of students' performance, and accepting students as members of the health care team, respecting and supporting them and protecting their rights. Learning from medical errors, analysis and reflection on errors should be part of the curriculum during the internship.
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Affiliation(s)
- Nastaran Heydarikhayat
- Nursing Department, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Nezar Ghanbarzehi
- Nursing Department, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Kimiya Sabagh
- Department of Pediatric Nursing, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran.
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Habihirwe P, Marini H, Wurtz B, Vermeulin T, Lottin M, Gehanno JF, Boulet L, Vergnes H, Edet S, Guet L, Le Roy F, Merle V. Compliance with good practice guidelines for the prevention of vascular access infections: the multi-centre PHYDEL survey in French haemodialysis units. J Hosp Infect 2023; 142:1-8. [PMID: 37734680 DOI: 10.1016/j.jhin.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND French guidelines for the prevention of vascular access infections in a haemodialysis setting were released in 2005. Compliance with these guidelines is currently unknown. The aim of this study was to assess compliance with the guidelines for vascular access infection prevention in French haemodialysis units, and to describe the difficulties reported. METHODS A cross-sectional survey was conducted between March and December 2019 in 200 haemodialysis units in France, selected at random. Data were collected via questionnaire, completed by telephone interview with an infection control practitioner. A practice was deemed compliant when >85% of units declared that they always complied with the guidelines. RESULTS In total, 103 units (51.5%) agreed to participate. Most practices complied with the guidelines; however, some practices did not reach the 85% compliance threshold for working in pairs when connecting central venous catheter (CVC) lines, performing hand hygiene before disconnecting lines, rinsing antiseptic soap before painting CVC exit site or arteriovenous fistula (AVF) puncture site, allowing antiseptic paint to dry, handling CVC branches with antiseptic impregnated gauze, performing hand hygiene after AVF compression with gloves, wearing protective eyewear when connecting/disconnecting CVC or when puncturing AVF, and wearing a gown when puncturing AVF. The most frequently reported difficulties were understaffing, difficulties with skin preparation because of exit site skin damage, and lack of buttonhole technical expertise. CONCLUSIONS Despite good overall compliance, this survey highlights some shortcomings in compliance with infection prevention guidelines, which could be associated with either higher risk of vascular access infection or increased blood-borne virus transmission.
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Affiliation(s)
- P Habihirwe
- Department of Infection Control, CHU Rouen, Rouen, France
| | - H Marini
- Department of Infection Control, CHU Rouen, Rouen, France; Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France
| | - B Wurtz
- Department of Infection Control, CHU Rouen, Rouen, France; Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France; REIN Registry, Agence de Biomédecine, Paris, France
| | - T Vermeulin
- Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France; Comprehensive Cancer Centre Henri Becquerel, UNICANCER, Rouen, France
| | - M Lottin
- Department of Infection Control, CHU Rouen, Rouen, France; Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France
| | - J F Gehanno
- Department of Occupational Health, CHU Rouen, Rouen, France
| | - L Boulet
- Department of Infection Control, CHU Rouen, Rouen, France; Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France
| | | | - S Edet
- REIN Registry, Agence de Biomédecine, Paris, France; Department of Nephrology and Haemodialysis, CHU Rouen, Rouen, France; ANIDER Rouen Normandie, Rouen, France
| | - L Guet
- CPIAS Normandie, Rouen, France
| | - F Le Roy
- Department of Nephrology and Haemodialysis, CHU Rouen, Rouen, France
| | - V Merle
- Department of Infection Control, CHU Rouen, Rouen, France; Research Group Dynamiques et Evènements des Soins et des Parcours, CHU Rouen, Rouen, France; REIN Registry, Agence de Biomédecine, Paris, France.
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Noghabi FA, Yousefi M, Golalipour E, Zarei A, Yousefi H, Sadeghi T. Lived experience caring for a child with Covid-19 disease: A phenomenological study. Heliyon 2023; 9:e18481. [PMID: 37533988 PMCID: PMC10392080 DOI: 10.1016/j.heliyon.2023.e18481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023] Open
Abstract
Background Caregivers of COVID-19 patients, including mothers with an infected child, are affected by adverse physical and psychological effects. Since mothers perform an important role in caring for a child with Covid-19, explaining their challenges and experiences positively affects the health conditions of children and society, in general. Aim This study aimed to explain mothers' experiences with children diagnosed with COVID-19, who were referred to Bandar Abbas Children's Hospital. Method The present study was qualitative and used the Van-Manen method. The statistical population included 13 mothers with children hospitalized for coronary heart disease and COVID-19, who were selected by purposive sampling. Semi-structured interviews were implemented to collect data until saturation. Data analysis was performed using MAXQDA 10 software. Lincoln and Guba's criteria were used to evaluate the data's accuracy and strength. Results The mean age of mothers participating in the study was 37.92 ± 4.87. On the other hand, the mean age of children was 5.15 ± 2.07 years. Three main themes and 13 sub-themes were extracted from the data analysis. The main themes were "Inability to Caring", "Mental and Physical drain" and "Conflict of Roles and Responsibilities". In this study, when a child develops COVID-19 disease, the mother experiences a series of negative emotions, which lead to feelings of helplessness and inability to care for the child. Conclusion Mental and physical manifestations strains were the most important issues that the mothers experienced. The majority of the participants need psychological support to cope with the disease. Therefore, it is recommended to make a proper design to psychologically and socially support these mothers, while alleviating the physical manifestations of their children's disease.
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Affiliation(s)
- Fariba Asadi Noghabi
- Mother and Child Welfare Research Center, Department of Nursing, School of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohsen Yousefi
- School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Elnaz Golalipour
- School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Aref Zarei
- Department of Nursing, School of Nursing and Midwifery, Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar, Abbas, Iran
| | - Hadi Yousefi
- Department of social medicine,faculty of medicine, Hormozgan University of Medical Sciences, Bandar,Abbas, Iran
| | - Tahereh Sadeghi
- Clinical Research Development Unit of Akbar Hospital, Department of Pediatrics, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Hessels AJ, Guo J, Johnson CT, Larson E. Impact of patient safety climate on infection prevention practices and healthcare worker and patient outcomes. Am J Infect Control 2023; 51:482-489. [PMID: 37088521 DOI: 10.1016/j.ajic.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Standard precautions may prevent patient health care associated infections and provider occupational exposures but are not often used by health care workers. A positive patient safety climate might contribute to improved adherence. The aim of this study was to determine the relationships among patient safety climate, standard precaution adherence, and health care worker exposures and HAIs. METHODS This multi-site, cross-sectional study included survey data from nurses on patient safety climate, observational data on adherence, and existing health care worker exposure and health care associated infections data. Data were aggregated to hospital unit level for correlational and multivariable regression analyses. RESULTS A total of 5,285 standard precaution observations and 452 surveys were collected across 43 hospital units. Observed adherence to all categories of standard precautions was 64.4%; there were significant differences by provider role. Multivariable models identified key predictors explaining sizeable variance in methicillin-resistant Staphylococcus aureus (41%), catheter associated urinary tract infections (23%), mucotaneous exposures (43%) and needlestick and sharps injuries (38%). DISCUSSION This study produced findings not previously published thus advancing the state of the science in patient and occupational health safety. These include identifying modifiable features of the safety climate and key organizational characteristics associated better outcomes. CONCLUSIONS In this novel study we identified that a positive patient safety climate and adherence to standard precautions predict key HAI and occupational health outcomes.
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Affiliation(s)
- Amanda J Hessels
- Columbia University, School of Nursing, New York, NY; Hackensack Meridian Health, Ann May Center, Neptune, NJ.
| | - Jingwen Guo
- Columbia University, Data Science Institute, New York, NY
| | | | - Elaine Larson
- Columbia University, School of Nursing, New York, NY
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Zhong J, Simpson KR, Spetz J, Gay CL, Fletcher J, Landstrom GL, Lyndon A. Linking Patient Safety Climate With Missed Nursing Care in Labor and Delivery Units: Findings From the LaborRNs Survey. J Patient Saf 2023; 19:166-172. [PMID: 36728161 PMCID: PMC10050088 DOI: 10.1097/pts.0000000000001106] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to explore the association of nurses' perceptions of patient safety climate with missed nursing care in labor and delivery (L&D) units. METHODS We recruited nurse respondents via email distribution of an electronic survey between February 2018 and July 2019. Hospitals with L&D units were recruited from states with projected availability of 2018 state inpatient data in the United States. Measures included the Safety Attitudes Questionnaire Safety Climate Subscale and the Perinatal Missed Care Survey. We estimated the relationship between safety climate and missed care using Kruskal-Wallis tests and mixed-effects linear regression. RESULTS The analytic sample included 3429 L&D registered nurses from 253 hospitals (response rate, 35%). A majority of respondents (65.7%) reported a perception of good safety climate in their units, with a mean score of 4.12 (±0.73) out of 5. The mean number of aspects of care occasionally, frequently, or always missed on respondents' units was 11.04 (±6.99) out of 25. χ2 Tests showed that six mostly commonly missed aspects of care (e.g., timely documentation) and three reasons for missed care (communications, material resources, and labor resources) were associated with safety climate groups ( P < 0.001). The adjusted mixed-effects model identified a significant association between better nurse-perceived safety climate and less missed care ( β = -2.65; 95% confidence interval, -2.97 to -2.34; P < 0.001) after controlling for years of experience and highest nursing education. CONCLUSIONS Our findings suggest that improving safety climate-for example, through better teamwork and communication-may improve nursing care quality during labor and birth through decreasing missed nursing care. Conversely, it is also possible that strategies to reduce missed care-such as staffing improvements-may improve safety climate.
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Affiliation(s)
- Jie Zhong
- Rory Meyers College of Nursing, New York University
| | | | - Joanne Spetz
- Phillip R. Lee Institute for Health Policy Studies, University of California San Francisco
| | - Caryl L. Gay
- Department of Family Health Care Nursing, University of California San Francisco School of Nursing
| | | | | | - Audrey Lyndon
- Rory Meyers College of Nursing, New York University
- Department of Family Health Care Nursing, University of California San Francisco School of Nursing
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Standard Precaution Knowledge and Behavioral Intentions Among Students in the Healthcare Field: A Cross-Sectional Study. THE JOURNAL OF NURSING RESEARCH : JNR 2022; 30:e229. [PMID: 35997613 DOI: 10.1097/jnr.0000000000000512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Infectious diseases are a major threat to healthcare workers and patients alike. Standard precautions (SPs) are a pivotal element in controlling their spread. However, worldwide reported compliance with SP guidelines is suboptimal among workers and students in the healthcare field. PURPOSE The objective of this study was to identify the knowledge and behavioral intent patterns of students in the healthcare field as well as the relationship of these patterns to the students' study program, clinical exposure, and attitudes. METHODS This cross-sectional study employed a web-based structured questionnaire. Participants were students of nursing, emergency medicine for paramedics, physiotherapy, and medicine studying at a public university in Israel. The questionnaire assessed SP-related knowledge and behavioral intent, perceptions of personal responsibility, and the presence of mentors as role models. The K -means clustering method was used. RESULTS The 259 students (33% response rate) who completed the questionnaire were enrolled as participants and divided into two knowledge and behavioral intent clusters. Cluster 1 ( n = 156) had a higher proportion of nursing students and a lower proportion of medical students than Cluster 2 ( n = 103). Emergency medicine for paramedics and physiotherapy students were more evenly distributed between the clusters. Participants who were classified in Cluster 1 reported higher intent with regard to proper hand hygiene, use of personal protective equipment, and decontamination practices. In multivariable analysis, only three variables predicted belonging to Cluster 1: nursing students, perception of their mentors as role models, and perception of having higher personal responsibility for microbiological safety. CONCLUSIONS We observed clear patterns of knowledge and behavior among the students in the healthcare field examined in this study. These patterns were influenced by profession, role mentoring, and sense of responsibility. This use of cluster analysis may contribute to the development of better SP educational endeavors. The patterns identified highlight the need for improved training and the importance of role modeling for healthcare students in all areas of specialization.
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Labrague LJ. Linking nurse practice environment, safety climate and job dimensions to missed nursing care. Int Nurs Rev 2021; 69:350-358. [PMID: 34878172 DOI: 10.1111/inr.12736] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 11/07/2021] [Indexed: 01/24/2023]
Abstract
AIM This study examined the aspects of the nurse practice environment and patient safety climate and the various job dimensions that contribute to the occurrence of missed nursing care. BACKGROUND Missed nursing care is a crucial healthcare concern that poses significant threats to patient safety. The available literature on missed nursing care is confined to high-resource nations, where hospital policies, mechanisms and processes to support professional nursing practice are well established. METHODS This is a multi-centre, cross-sectional study, using self-report scales, which involves 624 clinical nurses in selected hospitals in the Philippines. RESULTS Patient safety climate (β = -0.148, p = 0.001), decision authority (β = -0.101, p = 0.018) and staffing/resource adequacy (β = -0.086, p = 0.014) significantly predicted missed nursing care. Nurse, unit and hospital variables were not related with missed nursing care. DISCUSSION Nurses who perceived greater decision authority, positive safety climate and adequate staffing/resources were less likely to miss or omit patient care activities. CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY Institutional measures to foster decision authority in nurses, improve safety climate and address staffing/resource issues can be a viable solution to reduce the occurrence of missed nursing care.
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Affiliation(s)
- Leodoro J Labrague
- Graduate School, St. Paul University Philippines, Tuguegarao, Philippines
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KHosravi N, Alami A, Aelami MH, KHosrovan S. Improving Hand Hygiene Compliance of Intensive Care Unit by Using Pender's Model. Ethiop J Health Sci 2021; 31:553-560. [PMID: 34483612 PMCID: PMC8365475 DOI: 10.4314/ejhs.v31i3.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022] Open
Abstract
Background Hand hygiene (HH) compliance is an effective behavior in controlling hospital-acquired infection because the hand is the main means of transmitting infections in patient-medical staff communication as well as the inanimate environment. This study aimed to explore the effect of applying Pender's Health Promotion Model on the HH compliance of intensive care unit staff. Methods This quasi-experimental study with a single research group was conducted from January to July in 2019. The required data were collected from 90 staff of the intensive care units of Imam Reza Hospital in Mashhad, Iran through 1796 and 2343 opportunity of monitoring before and after the intervention. The data collection instruments were a standard HH observation form and a researcher-made HH questionnaire in the light of Pender's health promotion model. The data were statistically analyzed in SPSS using Paired-samples T-test and Chi-squared test. Results The mean age of the 90 included participants was 35.92 (± 6.5) years and the mean length of their work experience was 10 (±1.5). The hand hygiene index rose from 23% before the intervention to 41.4% after the intervention (p=0.001). Moreover, statistically significant differences were found in moments after touching surroundings (p=0.001), before and after touching a patient (p=0.001), and also in perceived barriers (p=0.015), interpersonal influences (p=0.008) and situational influences (p<0.001). Conclusion Pender's model showed to have improved the staff's HH compliance as a professional behavior.
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Affiliation(s)
- Nasrin KHosravi
- Department of Community Health Nursing & Management Nursing, School of Nursing, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Ali Alami
- Department of Social Medicine, Social Determinants of Health Research Center, School of Public Health Faculty, Gonabad University of Medical Sciences, Gonabad, Iran. Orcid ID: https://orcid.org/0000-0002-8882-3110
| | - Mohammad Hasan Aelami
- Department of Pediatrics, School of Medicine, Antimicrobial Resistance Research Center, Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shahla KHosrovan
- Department of Community Health Nursing & Management Nursing, School of Nursing, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad
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Karimi Z, Fereidouni Z, Behnammoghadam M, Alimohammadi N, Mousavizadeh A, Salehi T, Mirzaee MS, Mirzaee S. The Lived Experience of Nurses Caring for Patients with COVID-19 in Iran: A Phenomenological Study. Risk Manag Healthc Policy 2020; 13:1271-1278. [PMID: 32904130 PMCID: PMC7450521 DOI: 10.2147/rmhp.s258785] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/08/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This study aimed to explore the lived experiences of nurses caring for patients with COVID-19 in Iran. METHODS This study was a descriptive phenomenology. Sampling was purposefully performed, and participants were selected in terms of the inclusion criteria. Data were collected through semi-structured interviews using the WhatsApp mobile messaging application. Colaizzi's method was used to analyse the data. The criteria introduced by Lincoln and Guba were used for the study rigour. RESULTS The data were obtained from 12 nurses caring for patients with COVID-19. The mean age of the participants was 29.41 years (SD = 2.72) with a mean work experience of 6.75 years (SD = 2.52). Three main themes and six subthemes were identified: mental condition (subthemes included "anxiety and stress" and "fear"), emotional condition (subthemes included "suffering and affliction" and "waiting for death"), and care context (subthemes included "turmoil" and "lack of support and equipment"). CONCLUSION The results of this study show that nurses working in the wards and care centres designated for patients with COVID-19 are experiencing mental and emotional distress and are working in inadequate professional conditions.
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Affiliation(s)
- Zohreh Karimi
- Department of Operating Room, School of Paramedicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Zhila Fereidouni
- Department of Medical Surgical Nursing, Nursing School, Fasa University of Medical Sciences, Fasa, Fars, Iran
| | - Mohammad Behnammoghadam
- School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrollah Alimohammadi
- Critical Care Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Mousavizadeh
- Department of Biostatistics and Epidemiology, School of Health, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Tahmine Salehi
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Sobhan Mirzaee
- Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
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Vaismoradi M, Tella S, A. Logan P, Khakurel J, Vizcaya-Moreno F. Nurses' Adherence to Patient Safety Principles: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062028. [PMID: 32204403 PMCID: PMC7142993 DOI: 10.3390/ijerph17062028] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 12/18/2022]
Abstract
Background: Quality-of-care improvement and prevention of practice errors is dependent on nurses’ adherence to the principles of patient safety. Aims: This paper aims to provide a systematic review of the international literature, to synthesise knowledge and explore factors that influence nurses’ adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian, and Finnish languages were searched, using appropriate keywords to retrieve empirical articles published from 2010–2019. Using the theoretical domains of the Vincent’s framework for analysing risk and safety in clinical practice, we synthesized our findings according to ‘patient’, ‘healthcare provider’, ‘task’, ‘work environment’, and ‘organisation and management’. Findings: Six articles were found that focused on adherence to patient-safety principles during clinical nursing interventions. They focused on the management of peripheral venous catheters, surgical hand rubbing instructions, double-checking policies of medicines management, nursing handover between wards, cardiac monitoring and surveillance, and care-associated infection precautions. Patients’ participation, healthcare providers’ knowledge and attitudes, collaboration by nurses, appropriate equipment and electronic systems, education and regular feedback, and standardization of the care process influenced nurses’ adherence to patient-safety principles. Conclusions: The revelation of individual and systemic factors has implications for nursing care practice, as both influence adherence to patient-safety principles. More studies using qualitative and quantitative methods are required to enhance our knowledge of measures needed to improve nurse’ adherence to patient-safety principles and their effects on patient-safety outcomes.
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Affiliation(s)
- Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
- Correspondence: ; Tel.: +47-75517813
| | - Susanna Tella
- Faculty of Health and Social Care, LAB University of Applied Sciences, 53850 Lappeenranta, Finland;
| | - Patricia A. Logan
- Faculty of Science, Charles Sturt University, 2795 Bathurst, Australia;
| | - Jayden Khakurel
- Research Centre for Child Psychiatry, Department of Child Psychiatry, Faculty of Medicine, University of Turku, 20014 Turku, Finland;
| | - Flores Vizcaya-Moreno
- Nursing Department, Faculty of Health Sciences, University of Alicante, 03080 Alicante, Spain;
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Gustafsson N, Leino-Kilpi H, Prga I, Suhonen R, Stolt M. Missed Care from the Patient's Perspective - A Scoping Review. Patient Prefer Adherence 2020; 14:383-400. [PMID: 32161449 PMCID: PMC7049852 DOI: 10.2147/ppa.s238024] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 01/20/2020] [Indexed: 12/16/2022] Open
Abstract
Missed care, defined as any aspect of patient care that is omitted or delayed, is receiving increasing attention. It is primarily caused by the imbalance between patients' nursing care needs and the resources available, making it an ethical issue that challenges nurses' professional and moral values. In this scoping review, conducted using the five-stage approach by Arksey and O'Malley, our aim is to analyze the patients' perspective to missed care, as the topic has been mainly examined from nurses' perspective. The search was conducted in April 2019 in PubMed, CINAHL, PsycINFO, Web of Science, ProQuest and Philosophers Index databases using the following terms: omitted care, unfinished nursing care, care undone, care unfinished, missed care, care left undone, task undone and implicit rationing with no time limitation. The English-language studies where missed care was examined in the nursing context and had patients as informants on patient-reported missed care or patients' perceptions on nurse-reported missed care were selected for the review. Thirteen studies were included and analyzed with thematic content analysis. Twelve studies were quantitative in nature. Patients were able to report missed care, and mostly reported missed basic care, followed by missed communication with staff and problems with timeliness when they had to wait to get the help they needed. In statistical analysis, missed care was associated with patient-reported adverse events and patients' perceptions of staffing adequacy, and in patients' perception, it was mainly caused by lack of staff and insufficient experience. Furthermore, patients' health status, as opposed to gender, predicted missed care. The results concerning patients' age and education level were conflicting. Patients are able to identify missed care. However, further research is needed to examine patient-perceived missed care as well as to examine how patients identify missed care, and to get a clear definition of missed care.
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Affiliation(s)
- Noora Gustafsson
- Department of Nursing Science, University of Turku, Turku, Finland
- Correspondence: Noora Gustafsson Department of Nursing Science, 2 University of Turku, Turku20041, FinlandTel +358 440 276 600 Email
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Ivana Prga
- Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
- Welfare Division, Healthcare Services, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
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