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Péculo-Carrasco JA, Rodríguez-Ruiz HJ, Puerta-Córdoba A, Rodríguez-Bouza M, De La Fuente-Rodríguez JM, Failde I. Factors influencing witnesses' perception of patient safety during pre-hospital health care from emergency medical services: A multi-center cross-sectional study. Int Emerg Nurs 2024; 72:101383. [PMID: 38086283 DOI: 10.1016/j.ienj.2023.101383] [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: 06/11/2023] [Revised: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 01/28/2024]
Abstract
AIM To determine the factors related with the perception of feeling safe during pre-hospital emergency care. METHODS A multi-centred, cross-sectional study. Data collection from April 2021 to March 2022, in the Centro de Emergencias Sanitarias 061 (Andalusia, Spain). INCLUSION CRITERIA witnesses of health care by emergency medical services. EXCLUSION CRITERIA minors, or communication barriers. OUTCOME VARIABLE Witness Perceived Safety Scale ESPT10. The variables studied were related with sociodemographic data, the request for health care, the patient, the hospital transfer and patient safety incidents. A multivariate linear regression model was constructed for the dependent variable. The study followed STROBE statement. RESULTS Responses were obtained from 1400 witnesses. The linear regression model showed that the score on the scale increased as the witnesses felt more satisfied (B = 1.302; p < 0.001). On the contrary, the score was lower when the witness reported a patient safety incident (B = -2.856; p < 0.001 and B = -3.166; p < 0.001), or when the assistance took place in a public space (B = -0.722; p = 0.017). CONCLUSIONS The level of satisfaction, the occurrence of a patient safety incident, and the place of health care are related factors with the perception of the witnesses. The Witness Perceived Safety Scale ESPT10 could be considered a valid and useful patient safety indicator.
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Affiliation(s)
- Juan-Antonio Péculo-Carrasco
- Centro de Emergencias Sanitarias 061, Andalusian Health Service, Provincial Service 061 in Cádiz. Regional Government of Andalusia, Spain.
| | - Hugo-José Rodríguez-Ruiz
- Centro de Emergencias Sanitarias 061, Andalusian Health Service, Provincial Service 061 in Cádiz. Regional Government of Andalusia, Spain
| | - Antonio Puerta-Córdoba
- Centro de Emergencias Sanitarias 061, Andalusian Health Service, Provincial Service 061 in Cádiz. Regional Government of Andalusia, Spain
| | - Mónica Rodríguez-Bouza
- Centro de Emergencias Sanitarias 061, Andalusian Health Service, Provincial Service 061 in Cádiz. Regional Government of Andalusia, Spain
| | | | - Inmaculada Failde
- Institute of Research and Innovation of Biomedical Sciences of the Province of Cádiz (INiBICA), Spain; Preventive Medicine and Public Health, University of Cádiz, Spain
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Romero-Sánchez JM, Sánchez-Almagro CP, White-Ríos M, Paloma-Castro O. Prevalence and clustering of NANDA-I nursing diagnoses in the pre-hospital emergency care setting: A retrospective records review study. J Clin Nurs 2024. [PMID: 38235516 DOI: 10.1111/jocn.16996] [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: 08/06/2023] [Revised: 12/21/2023] [Accepted: 01/07/2024] [Indexed: 01/19/2024]
Abstract
AIM To determine the prevalence and clustering of NANDA-International nursing diagnoses in patients assisted by pre-hospital emergency teams. DESIGN Retrospective descriptive study of electronic record review. METHODS Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two-step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020. RESULTS Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six-cluster solution (n = 26.788) was found. Five clusters had a single high-prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co-occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051). CONCLUSION Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre-hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre-hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre-hospital clinical setting. IMPACT What problem did the study address? There are different models of pre-hospital emergency care services. The use of standardized nursing languages in the pre-hospital setting is not homogeneous. Studies on NANDA-I nursing diagnoses in the pre-hospital context are scarce, and those available are conducted on small samples. What were the main findings? This paper reports the study with the largest sample among the few published on NANDA-I nursing diagnoses in the pre-hospital care setting. Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients' safety/protection and coping/stress tolerance. Patients attended by pre-hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers. Where and on whom will the research have an impact? Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre-hospital setting, increasing the evidence of individualized and standardized care plans for pre-hospital care. REPORTING METHOD STROBE checklist has been used as a reporting method. NO PATIENT OR PUBLIC CONTRIBUTION Only patients' records were reviewed without further involvement.
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Affiliation(s)
- José Manuel Romero-Sánchez
- Nursing and Physiotherapy Department, Faculty of Nursing and Physiotherapy, Universidad de Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
| | - César Pedro Sánchez-Almagro
- Medical Emergency Center 061 (CES 061), Andalusian Health Service, Provincial Service 061 in Cádiz, Regional Government of Andalusia, Cádiz, Spain
| | - Melanie White-Ríos
- Hospital Punta de Europa, Andalusian Health Service, Algeciras, Cádiz, Spain
| | - Olga Paloma-Castro
- Nursing and Physiotherapy Department, Faculty of Nursing and Physiotherapy, Universidad de Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
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Larsson F, Engström Å, Rysst Gustafsson S, Strömbäck U. Feeling Safe in the Perioperative Period: Experiences from Patients Undergoing Orthopedic Day Surgery. SAGE Open Nurs 2024; 10:23779608241258562. [PMID: 38828401 PMCID: PMC11140583 DOI: 10.1177/23779608241258562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/11/2024] [Accepted: 05/14/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction Day surgery is often preferred by patients, but it can pose challenges in self-management after discharge. In addition, patients undergoing orthopedic surgery report poorer rates of postoperative recovery than patients undergoing general surgery. Understanding patients' perceptions of feeling safe while undergoing surgery facilitates individualized care and is important since it may affect their recovery. Objective The aim of this study was to describe patients' perceptions of feeling safe in the perioperative period when undergoing orthopedic day surgery under regional anesthesia. Methods The design was qualitative and descriptive. Data were collected through a cross-sectional questionnaire containing open-ended questions. Qualitative content analysis with an inductive approach was used for data analysis. Participants' characteristics were presented descriptively. The study population consisted of a consecutive sample of 97 patients who had undergone orthopedic day surgery under regional anesthesia between March and October 2022. Results The categorization process resulted in the development of two categories describing participants' experience of perioperative feelings of safety when undergoing orthopedic day surgery: having someone near and having a sense of control. The results indicate that the relationship between patients and staff and the perceived feeling of control and participation are factors influencing patients' perception of feeling safe in the perioperative period. Conclusions In perioperative care, nurses play a vital role in fostering patients' sense of safety by establishing relationships. This ensures that patients can be actively engaged in their own care. Patients also need access to professional and competent staff who strives to add a personal touch and considers their perspective. Since patients undergoing orthopedic day surgery might face a more demanding postoperative recovery than they had initially anticipated, further research is suggested to explore the association between a perceived feeling of safety and postoperative recovery.
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Affiliation(s)
- Fanny Larsson
- Division of Nursing and Medical Technology, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Åsa Engström
- Division of Nursing and Medical Technology, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Silje Rysst Gustafsson
- Division of Nursing and Medical Technology, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Ulrica Strömbäck
- Division of Nursing and Medical Technology, Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Krane A, Pettersen G, Lappegård KT, Hanssen TA. In need of percutaneous coronary intervention in an arctic setting- patients' experience of safety and quality of care: a qualitative study. Int J Circumpolar Health 2023; 82:2273016. [PMID: 37899000 PMCID: PMC10997295 DOI: 10.1080/22423982.2023.2273016] [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: 05/16/2023] [Accepted: 10/16/2023] [Indexed: 10/31/2023] Open
Abstract
Patients with coronary heart disease need timely treatment for survival and optimum prognosis. There is limited research exploring patients' experience regarding distance to percutaneous coronary intervention. The aim was to explore patients' experiences of aspects contributing to safety and quality of care regarding health services following percutaneous coronary intervention in Northern Norway. A qualitative explorative design was used, and 15 patients participated in individual semi-structured interviews 9-16 months after treatment. The reflexive thematic analysis revealed two main themes: (1) being part of a safe system and (2) adapting to new everyday life. Feeling safe and experiencing quality care depended on whether the participants were heard within the system upon first contact, whether help was available when needed, the travel time for treatment, sufficient information, the competency of care provided by healthcare professionals, and how follow-up services were organised when adapting to everyday life. To conclude, patients undergoing percutaneous coronary intervention in an arctic context perceived healthcare services as safe when the system delivered continuous care throughout all levels. Consistent optimisation of transport time and distance to treatment, especially for rural patients, and extensively focusing on follow-up services, can contribute to improving safety and quality of care.
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Affiliation(s)
- Anette Krane
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Division of Medicine, Department of Cardiology, Nordland Hospital, Bodø, Norway
| | - Gunn Pettersen
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Knut Tore Lappegård
- Division of Medicine, Department of Cardiology, Nordland Hospital, Bodø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Tove Aminda Hanssen
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Cardiology, University Hospital of North Norway, Tromsø, Norway
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5
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Larsson F, Strömbäck U, Rysst Gustafsson S, Engström Å. Perception of feeling safe perioperatively: a concept analysis. Int J Qual Stud Health Well-being 2023; 18:2216018. [PMID: 37210740 DOI: 10.1080/17482631.2023.2216018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/16/2023] [Indexed: 05/23/2023] Open
Abstract
PURPOSE The purpose of this study was to explore the concept of feeling safe, from the patient perspective, in a perioperative context. METHOD The eight-step concept analysis approach proposed by Walker and Avant was utilized to examine the attributes of feeling safe. Uses of the concept, defining attributes as well as antecedents, consequences and empirical referents are presented to describe the concept. Case examples are provided in order to assist the understanding of the defining attributes. RESULTS Feeling safe is defined as: a person that does not feel worried or threatened. Three attributes were identified: Participation, Control and Presence. Knowledge and Relationship are the antecedents of feeling safe, while Feeling Acknowledged and Trust are the consequences. Empirical referents are explored in order to find a way to measuring the perceived feeling of safety. CONCLUSION This concept analysis underscores the importance of including patients' perceptions in traditional patient safety work. Patients who feel safe perceive that they participate in their care, that they are in control, and that they feel the presence of both healthcare staff and relatives. The perceived feeling of security could, by extension, promote the postoperative recovery of patients undergoing surgery by positively affect the process of recovery.
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Affiliation(s)
- Fanny Larsson
- Division of Nursing and Medical Technology, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Ulrica Strömbäck
- Division of Nursing and Medical Technology, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Silje Rysst Gustafsson
- Division of Nursing and Medical Technology, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Åsa Engström
- Division of Nursing and Medical Technology, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
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6
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Satchell E, Carey M, Dicker B, Drake H, Gott M, Moeke-Maxwell T, Anderson N. Family & bystander experiences of emergency ambulance services care: a scoping review. BMC Emerg Med 2023; 23:68. [PMID: 37316865 DOI: 10.1186/s12873-023-00829-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/23/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Emergency ambulance personnel respond to a variety of incidents in the community, including medical, trauma and obstetric emergencies. Family and bystanders present on scene may provide first aid, reassurance, background information or even act as proxy decision-makers. For most people, involvement in any event requiring an emergency ambulance response is a stressful and salient experience. The aim of this scoping review is to identify and synthesise all published, peer-reviewed research describing family and bystanders' experiences of emergency ambulance care. METHODS This scoping review included peer-reviewed studies that reported on family or bystander experiences where emergency ambulance services responded. Five databases were searched in May 2022: Medline, CINAHL, Scopus, ProQuest Dissertation & Theses and PsycINFO. After de-duplication and title and abstract screening, 72 articles were reviewed in full by two authors for inclusion. Data analysis was completed using thematic synthesis. RESULTS Thirty-five articles reporting heterogeneous research designs were included in this review (Qualitative = 21, Quantitative = 2, Mixed methods = 10, Evidence synthesis = 2). Thematic synthesis developed five key themes characterising family member and bystander experiences. In an emergency event, family members and bystanders described chaotic and unreal scenes and emotional extremes of hope and hopelessness. Communication with emergency ambulance personnel played a key role in family member and bystander experience both during and after an emergency event. It is particularly important to family members that they are present during emergencies not just as witnesses but as partners in decision-making. In the event of a death, family and bystanders want access to psychological post-event support. CONCLUSION By incorporating patient and family-centred care into practice emergency ambulance personnel can influence the experience of family members and bystanders during emergency ambulance responses. More research is needed to explore the needs of diverse populations, particularly regarding differences in cultural and family paradigms as current research reports the experiences of westernised nuclear family experiences.
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Affiliation(s)
- Eillish Satchell
- Te Ārai Palliative & End of Life Research Group, School of Nursing University of Auckland , Private Bag 92019, Auckland, 1142, New Zealand
| | - Melissa Carey
- Te Ārai Palliative & End of Life Research Group, School of Nursing University of Auckland , Private Bag 92019, Auckland, 1142, New Zealand
| | - Bridget Dicker
- Paramedicine Research Unit, Auckland University of Technology, Auckland, New Zealand
- St John, New Zealand (Hato Hone Aotearoa), Auckland, New Zealand
| | - Haydn Drake
- St John, New Zealand (Hato Hone Aotearoa), Auckland, New Zealand
| | - Merryn Gott
- Te Ārai Palliative & End of Life Research Group, School of Nursing University of Auckland , Private Bag 92019, Auckland, 1142, New Zealand
| | - Tess Moeke-Maxwell
- Te Ārai Palliative & End of Life Research Group, School of Nursing University of Auckland , Private Bag 92019, Auckland, 1142, New Zealand
| | - Natalie Anderson
- Te Ārai Palliative & End of Life Research Group, School of Nursing University of Auckland , Private Bag 92019, Auckland, 1142, New Zealand.
- Adult Emergency Department, Auckland City Hospital, Auckland Mail Centre, Private Bag 92024, Auckland, 1142, New Zealand.
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7
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Venesoja A, Tella S, Castrén M, Lindström V. Finnish emergency medical services managers' and medical directors' perceptions of collaborating with patients concerning patient safety issues: a qualitative study. BMJ Open 2023; 13:e067754. [PMID: 37037618 PMCID: PMC10111928 DOI: 10.1136/bmjopen-2022-067754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
OBJECTIVES This study aimed to describe emergency medical services (EMS) managers' and medical directors' perceptions of collaborating with patients concerning patient safety issues in the EMS. DESIGN The study used a descriptive qualitative approach. Five focus groups and two individuals were interviewed using a semi-structured guide with open-ended questions. The data were analysed using reflexive thematic analysis. Consolidated criteria for Reporting Qualitative research was used to guide the reporting of this study. SETTING EMS organisations from Finland's five healthcare districts. PARTICIPANTS EMS medical directors (n=5) and EMS managers (n=14). Purposive sampling was used. RESULTS Two main themes, 'Patient safety considered an organisational responsibility' and 'EMS patients' opportunities and obstacles to speaking up', were generated from the data. Under the main theme, 'Patient safety considered an organisational responsibility', were three subthemes: patient safety considered part of the quality in EMS, system-level models for handling and observing patient safety in EMS, and management's ability to find a balance when using patients' feedback for patient safety development. Under the other main theme were four subthemes: 'social and feedback skills of EMS personnel and management', 'managements' assumptions of patients' reasons for not speaking up', 'EMS organisations' different but unsystematic ways of collecting feedback' and 'management's openness to develop patient participation'. CONCLUSIONS The nature of the EMS organisations and EMS assignments could affect a patient's participation in developing patient safety in EMS. However, EMS managers and medical directors are receptive to collaborating with patients concerning patient safety issues if they have sufficient resources and a coherent way to collect patient safety concerns. The management is open to collaborating with patients, but there is a need to develop a systematic method with enough resources to facilitate the management's collaborating with patients.
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Affiliation(s)
- Anu Venesoja
- Department of Emergency Care Services, South Karelia Social and Health Care District, Lappeenranta, Finland
- Department of Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Health & Wellbeing, LAB University of Applied Sciences - Lappeenrannan Kampus, Lappeenranta, Finland
| | - Susanna Tella
- Health & Wellbeing, LAB University of Applied Sciences - Lappeenrannan Kampus, Lappeenranta, Finland
- Department of Nursing Science, University of Eastern Finland, Faculty of Health Sciences, Kuopio, Finland
| | - Maaret Castrén
- Department of Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Veronica Lindström
- Department of Neurobiology, Care Sciences, and Society Division of Nursing, Karolinska Institutet, Stockholm, Sweden
- Samariten Ambulance, Stockholm, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
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8
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Kauppi W, Axelsson C, Herlitz J, Jiménez-Herrera M, Palmér L. Lived experiences of being cared for by ambulance clinicians when experiencing breathlessness-A phenomenological study. Scand J Caring Sci 2023; 37:207-215. [PMID: 35875847 DOI: 10.1111/scs.13108] [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: 02/22/2022] [Revised: 06/29/2022] [Accepted: 07/10/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Breathlessness is a serious and distressing symptom and a common reason why patients require prehospital care by ambulance clinicians. However, little is known about how patients experience this care when they are in a state of breathlessness. AIM The aim of this study is to describe the lived experiences of being cared for by ambulance clinicians when experiencing breathlessness. METHODS Fourteen lifeworld interviews were conducted with patients who experienced breathlessness and were cared for by ambulance clinicians. The interviews were analysed using a qualitative phenomenological approach. FINDINGS The essential meaning of being cared for by ambulance clinicians when experiencing breathlessness is described in two ways: existential humanising care, in which the experience is that of being embraced by a genuine presence or existential dehumanising care, in which feeling exposed to an objectifying presence is the main experience. This meaning has four constituents: surrendering to and trusting in the care that will come; being exposed to an objectifying presence is violating; being embraced by a genuine presence is relieving; and knowing is dwelling. CONCLUSION The findings reveal that the ability of ambulance clinicians to provide existential humanising and trustful care, which is the foundation of professional judgement, was essential in how patients responded to and handled the overall situation when breathlessness.
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Affiliation(s)
- Wivica Kauppi
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,PreHospen- Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Christer Axelsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,PreHospen- Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Emergency Medical Service (EMS), Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Johan Herlitz
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,PreHospen- Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Maria Jiménez-Herrera
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Nursing Department, Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Lina Palmér
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Venesoja A, Lindström V, Castrén M, Tella S. Prehospital nursing students' experiences of patient safety culture in emergency medical services-A qualitative study. J Clin Nurs 2023; 32:847-858. [PMID: 35672936 PMCID: PMC10083998 DOI: 10.1111/jocn.16396] [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: 02/08/2022] [Revised: 05/17/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To describe prehospital nursing students' experiences of patient safety culture in emergency medical services during their internship. BACKGROUND Patient safety culture in the emergency medical services is a complex phenomenon including more than organisational policies and practices and professionals' technical skills. DESIGN The descriptive qualitative approach used the Sharing Learning from Practice to improve Patient Safety Learning Event Recording Tool, which includes both open-ended and structured questions. METHODS Purposeful sampling was used, and data were collected from graduating prehospital nursing students (n = 17) from three Finnish Universities of Applied Sciences. Open-ended questions were reviewed using thematic analysis, and frequencies and percentages were derived from structured questions. COREQ guidelines were used to guide this study. RESULTS Four themes were identified during the thematic analysis: environmental and other unexpected factors in emergency medical services, working practices and professionalism in emergency medical services, teamwork in emergency medical services and feelings related to patient safety events in emergency medical services. Patient safety events described by students were seldom reported in the healthcare system or patient files. According to the students, such events were most likely related to communication, checking/verification and/or teamwork. CONCLUSIONS This study shows that prehospital nursing students can produce important information about patient safety events and the reasons that contributed to those events. Therefore, emergency medical services organisations and managers should use students' observations to develop a patient safety culture in emergency medical services. RELEVANCE TO CLINICAL PRACTICE Understanding how prehospital nursing students have experienced patient safety culture during their internships on ambulances can support educational institutions, together with emergency medical services organisations and managers, to improve policies for students to express patient safety concerns as well as patient safety successes.
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Affiliation(s)
- Anu Venesoja
- South Carelia Social and Healthcare District, Lappeenranta, Finland.,Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Veronica Lindström
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.,Samariten Ambulance, Stockholm, Sweden.,Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
| | - Maaret Castrén
- Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Susanna Tella
- LAB University of Applied Sciences, Lappeenranta, Finland.,University of Eastern Finland, Kuopio, Finland
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Péculo‐Carrasco J, Luque‐Hernández MJ, Rodríguez‐Ruiz H, Chacón‐Manzano C, Failde I. Factors influencing the perception of feeling safe in pre‐hospital emergency care: A mixed‐methods systematic review. J Clin Nurs 2022. [DOI: 10.1111/jocn.16595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Juan‐Antonio Péculo‐Carrasco
- Centro de Emergencias Sanitarias 061, Andalusian Health Service Provincial Service 061 in Cádiz, Regional Government of Andalusia Cádiz Spain
| | - María José Luque‐Hernández
- Centro de Emergencias Sanitarias 061, Andalusian Health Service Central Headquaters, Regional Government of Andalusia Málaga Spain
| | - Hugo‐José Rodríguez‐Ruiz
- Centro de Emergencias Sanitarias 061, Andalusian Health Service Provincial Service 061 in Cádiz, Regional Government of Andalusia Cádiz Spain
| | - Coral Chacón‐Manzano
- Centro de Emergencias Sanitarias 061, Andalusian Health Service Provincial Service 061 in Córdoba, Regional Government of Andalusia Córdoba Spain
| | - Inmaculada Failde
- Institute of Research and Innovation of Biomedical Sciences of the Province of Cádiz (INiBICA) Preventive Medicine and Public Health University of Cádiz Cádiz Spain
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11
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Jang SG, Park E, Lee J, Choi JE, Lee SI, Han H, Park E, Lee W. An Exploration Into Patients' Experiences That Make Them Feel Safe During Hospitalization: A Qualitative Study. J Korean Med Sci 2022; 37:e256. [PMID: 35996933 PMCID: PMC9424743 DOI: 10.3346/jkms.2022.37.e256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/14/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Patient safety is a crucial indicator of health care quality. It is necessary to check the subjective perception of patient safety from the patient's point of view as a consumer of healthcare services. To identify patients' experiences of safety and the themes that constitute the patients' feeling of safety during hospitalization. METHODS A qualitative study, comprising five focus group discussions (seven people each), was conducted in South Korea between May and July 2018. Patients who were hospitalized for at least three days within one year were included. Researchers analyzed the transcribed script, and a content analysis was performed to describe patients' hospitalized experiences of safety. RESULTS A total of 35 patients with an average age of 45.4 years participated in the study, and had experience of hospitalization for up to 32 days. The findings revealed four core themes and 14 sub-themes. Patients wanted to take initiative in controlling his/her reception of information and wanted healthcare providers to make the patient feel safe. Patients felt safe when hospitals provided unstinted and generous support. Also, public sentiment about national healthcare and safety made an effect on patient safety sentiment. CONCLUSION Patients felt safe during hospitalization not only because of the explanation, attitude, and professionalism of the healthcare providers but also because of the support, system, and procedure of the medical institution. Healthcare providers and medical institutions should strive to narrow the gap in patient safety awareness factors through activities with patients. Furthermore, the government and society should make an effort to create a safe medical environment and social atmosphere.
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Affiliation(s)
| | - Eunji Park
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Jessie Lee
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Ji Eun Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Sang-Il Lee
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Haerim Han
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Eunjung Park
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Won Lee
- Department of Nursing, Chung-Ang University, Seoul, Korea.
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Sánchez-Almagro CP, Romero-Sánchez JM, White-Ríos M, González Del Pino CA, Paloma-Castro O. NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care. J Adv Nurs 2022; 78:3273-3289. [PMID: 35506570 PMCID: PMC9545537 DOI: 10.1111/jan.15280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/12/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
Aim To determine the prevalence of NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre‐hospital emergency care setting. Design Retrospective descriptive study of electronic record review. Methods Eight thousand three hundred three episodes recorded during the year 2019 were recovered from the electronic health records of a public emergency care agency. The prevalence of NANDA International nursing diagnosis, Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions was determined. A cross‐tabulation analysis was performed to determine the linkages. Data were accessed in November 2020. Results NANDA International nursing diagnoses Anxiety (00146) and Fear (00148) represented more than 90% of the diagnoses recorded in the domain. Anxiety level (1211) and emotional support (5270) were the most recorded Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions, with almost 20% and 5% of total records, respectively. The linkage between nursing diagnosis Anxiety (00146), outcome Anxiety level (1211) and intervention Anxiety reduction (5820) was the most recorded with slightly more than 3% of the total. Conclusion Eight different NANDA International nursing diagnoses in the coping/stress tolerance domain were recorded. Nursing Outcomes Classification outcomes were selected aimed mainly at psychological well‐being and Nursing Interventions Classification interventions to support coping. In general, linkages were aimed to provide emotional support, physical well‐being, information, education and safety. Impact This study showed that pre‐hospital emergency care nurses diagnose and treat human responses in the coping/stress tolerance domain. Expert consensus‐based linkages may be complemented by the results of this study, increasing the levels of evidence of both individualized and standardized care plans for critical patients assisted by pre‐hospital emergency care nurses.
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Affiliation(s)
- César Pedro Sánchez-Almagro
- Empresa Pública de Emergencias Sanitarias (EPES), Servicio Provincial de Cádiz, Cádiz, Spain.,Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 MELES "Nursing methods and Standardized Languages", Universidad de Cádiz, Cádiz, Spain
| | - José Manuel Romero-Sánchez
- Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 MELES "Nursing methods and Standardized Languages", Universidad de Cádiz, Cádiz, Spain.,Nursing and Physiotherapy Department, Faculty of Nursing and Physiotherapy, Universidad de Cádiz, Cádiz, Spain
| | | | | | - Olga Paloma-Castro
- Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 MELES "Nursing methods and Standardized Languages", Universidad de Cádiz, Cádiz, Spain.,Nursing and Physiotherapy Department, Faculty of Nursing and Physiotherapy, Universidad de Cádiz, Cádiz, Spain
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Howe EG. Beyond the Basics: More Ways that Ethics Consultants Can Help Patients. THE JOURNAL OF CLINICAL ETHICS 2022. [DOI: 10.1086/jce2022331003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Becker J, Hugelius K. Driving the ambulance: an essential component of emergency medical services: an integrative review. BMC Emerg Med 2021; 21:160. [PMID: 34922453 PMCID: PMC8684175 DOI: 10.1186/s12873-021-00554-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/06/2021] [Indexed: 04/28/2023] Open
Abstract
Background The transport of patients from one location to another is a fundamental part of emergency medical services. However, little interest has been shown in the actual driving of the ambulance. Therefore, this review aimed to investigate how the driving of the ambulance affects the patient and the medical care provided in an emergency medical situation. Methods A systematic integrative review using both quantitative and qualitative designs based on 17 scientific papers published between 2011 and 2020 was conducted. Results Ambulance driving, both the actual speed, driving pattern, navigation, and communication between the driver and the patient, influenced both the patient’s medical condition and the possibility of providing adequate care during the transport. The driving itself had an impact on prehospital time spent on the road, safety, comfort, and medical issues. The driver’s health and ability to manage stress caused by traffic, time pressure, sirens, and disturbing moments also significantly influenced ambulance transport safety. Conclusions The driving of the ambulance had a potential effect on patient health, wellbeing, and safety. Therefore, driving should be considered an essential part of the medical care offered within emergency medical services, requiring specific skills and competence in both medicine, stress management, and risk approaches in addition to the technical skills of driving a vehicle. Further studies on the driving, environmental, and safety aspects of being transported in an ambulance are needed from a patient’s perspective.
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Affiliation(s)
- Julia Becker
- Institute for Disaster and Emergency Management, 141 69, Berlin, Germany
| | - Karin Hugelius
- Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden.
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