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Saarijärvi M, Bratt EL. When face-to-face interviews are not possible: tips and tricks for video, telephone, online chat, and email interviews in qualitative research. Eur J Cardiovasc Nurs 2021; 20:392-396. [PMID: 33893797 PMCID: PMC8135391 DOI: 10.1093/eurjcn/zvab038] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 11/13/2022]
Abstract
Face-to-face interviews have long been the norm for conducting qualitative interviews in healthcare research. However, the Covid-19 pandemic has accelerated the need to explore alternative methods. This, along with the swift digitalization of healthcare, has led to video, telephone, and online interactions becoming increasingly used. The use of new techniques to carry out interviews through video, telephone, and online applications all come with benefits and drawbacks. In this article, three ways of collecting data through qualitative interviews are described and their uses exemplified through a project investigating the impact of a transition program for adolescents with congenital heart disease.
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Affiliation(s)
- Markus Saarijärvi
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Ewa-Lena Bratt
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatric Cardiology, Queen Silvia’s Childreńs Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
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Freeman R, Smith A, Dickinson S, Tschannen D, James S, Friedman C. Specialty Linens and Pressure Injuries in High-Risk Patients in the Intensive Care Unit. Am J Crit Care 2017; 26:474-481. [PMID: 29092870 DOI: 10.4037/ajcc2017530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND The cardiovascular and surgical intensive care units had the highest unit-acquired pressure injury rates at an institution. Patients in these units had multiple risk factors for pressure injuries. Various interventions had been used to minimize pressure injuries, with limited results. OBJECTIVES To evaluate the effect of specialty linens on the rate of pressure injuries in high-risk patients. The specialty linen was a synthetic silklike fabric that addressed the microclimate surrounding the patient, with the purpose of minimizing friction, shear, moisture, and heat. METHODS The specialty linen was tried on 24 beds in the cardiovascular intensive care unit and 20 beds in the surgical intensive care unit, including sheets, underpads, gowns, and pillow cases. Data obtained from a retrospective review of electronic health records were compared for 9 months before and 10 months after specialty linens were implemented. RESULTS Total unit-acquired pressure injury rates for both units combined declined from 7.7% (n = 166) before to 5.3% (n = 95) after the intervention. The intervention was associated with a significant reduction in posterior (coccyx, sacrum, back, buttock, heel, and spine) pressure injury rates, from 5.2% (n = 113) before to 2.8% (n = 51) after specialty linens were implemented (P < .001). CONCLUSION Addressing the microclimate, friction, and shear by using specialty linens reduces the number of posterior pressure injuries. The use of specialty linens in addition to standard techniques for preventing pressure injuries can help prevent pressure injuries from developing in high-risk patients in intensive care units.
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Affiliation(s)
- Regi Freeman
- Regi Freeman is a clinical nurse specialist in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, University of Michigan Health System, and a member of the clinical adjunct faculty, University of Michigan School of Nursing, Ann Arbor, Michigan. Andrew Smith is a staff nurse in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, Sharon Dickinson is a clinical nurse specialist in the surgical intensive care unit, and Candace Friedman is a senior project manager, Office of Clinical Safety, University of Michigan Health System, Ann Arbor, Michigan. Dana Tschannen is a clinical associate professor, vice chair of the Department of Systems, Population and Leadership, and director of the post-Master's DNP program, and Shandra James is a clinical assistant professor, University of Michigan School of Nursing, Ann Arbor, Michigan.
| | - Andrew Smith
- Regi Freeman is a clinical nurse specialist in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, University of Michigan Health System, and a member of the clinical adjunct faculty, University of Michigan School of Nursing, Ann Arbor, Michigan. Andrew Smith is a staff nurse in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, Sharon Dickinson is a clinical nurse specialist in the surgical intensive care unit, and Candace Friedman is a senior project manager, Office of Clinical Safety, University of Michigan Health System, Ann Arbor, Michigan. Dana Tschannen is a clinical associate professor, vice chair of the Department of Systems, Population and Leadership, and director of the post-Master's DNP program, and Shandra James is a clinical assistant professor, University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Sharon Dickinson
- Regi Freeman is a clinical nurse specialist in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, University of Michigan Health System, and a member of the clinical adjunct faculty, University of Michigan School of Nursing, Ann Arbor, Michigan. Andrew Smith is a staff nurse in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, Sharon Dickinson is a clinical nurse specialist in the surgical intensive care unit, and Candace Friedman is a senior project manager, Office of Clinical Safety, University of Michigan Health System, Ann Arbor, Michigan. Dana Tschannen is a clinical associate professor, vice chair of the Department of Systems, Population and Leadership, and director of the post-Master's DNP program, and Shandra James is a clinical assistant professor, University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Dana Tschannen
- Regi Freeman is a clinical nurse specialist in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, University of Michigan Health System, and a member of the clinical adjunct faculty, University of Michigan School of Nursing, Ann Arbor, Michigan. Andrew Smith is a staff nurse in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, Sharon Dickinson is a clinical nurse specialist in the surgical intensive care unit, and Candace Friedman is a senior project manager, Office of Clinical Safety, University of Michigan Health System, Ann Arbor, Michigan. Dana Tschannen is a clinical associate professor, vice chair of the Department of Systems, Population and Leadership, and director of the post-Master's DNP program, and Shandra James is a clinical assistant professor, University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Shandra James
- Regi Freeman is a clinical nurse specialist in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, University of Michigan Health System, and a member of the clinical adjunct faculty, University of Michigan School of Nursing, Ann Arbor, Michigan. Andrew Smith is a staff nurse in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, Sharon Dickinson is a clinical nurse specialist in the surgical intensive care unit, and Candace Friedman is a senior project manager, Office of Clinical Safety, University of Michigan Health System, Ann Arbor, Michigan. Dana Tschannen is a clinical associate professor, vice chair of the Department of Systems, Population and Leadership, and director of the post-Master's DNP program, and Shandra James is a clinical assistant professor, University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Candace Friedman
- Regi Freeman is a clinical nurse specialist in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, University of Michigan Health System, and a member of the clinical adjunct faculty, University of Michigan School of Nursing, Ann Arbor, Michigan. Andrew Smith is a staff nurse in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, Sharon Dickinson is a clinical nurse specialist in the surgical intensive care unit, and Candace Friedman is a senior project manager, Office of Clinical Safety, University of Michigan Health System, Ann Arbor, Michigan. Dana Tschannen is a clinical associate professor, vice chair of the Department of Systems, Population and Leadership, and director of the post-Master's DNP program, and Shandra James is a clinical assistant professor, University of Michigan School of Nursing, Ann Arbor, Michigan
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Chopra V, Kuhn L, Ratz D, Flanders SA, Krein SL. Vascular nursing experience, practice knowledge, and beliefs: Results from the Michigan PICC1 survey. J Hosp Med 2016; 11:269-75. [PMID: 26717423 DOI: 10.1002/jhm.2523] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 10/28/2015] [Accepted: 11/08/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND Peripherally inserted central catheters (PICCs) are increasingly used in hospitalized patients. Yet, little is known about the vascular access nurses who often place them. METHODS We conducted a Web-based survey to assess vascular access nursing experience, practice, knowledge, and beliefs related to PICC insertion and care in 47 Michigan hospitals. RESULTS The response rate was 81% (172 received invitations, 140 completed the survey). More than half of all respondents (58%) reported placing PICCs for ≥5 years, and 23% had obtained dedicated vascular access certification. The most common reported indications for PICC insertion included intravenous antibiotics, difficult venous access, and chemotherapy. Many respondents (46%) reported placing a PICC in a patient receiving dialysis; however, 91% of these respondents reported receiving approval from nephrology prior to insertion. Almost all respondents (91%) used ultrasound to find a suitable vein for PICC insertion, and 76% used electrocardiography guidance to place PICCs. PICC occlusion was reported as the most frequently encountered complication, followed by device migration and deep vein thrombosis. Although 94% of respondents noted that their hospitals tracked the number of PICCs placed, only 40% reported tracking duration of PICC use. Relatedly, 30% of nurses reported that their hospitals had a written policy to evaluate PICC necessity or appropriateness. CONCLUSION This survey of vascular nursing experiences highlights opportunities to improve practices such as avoiding PICC use in dialysis, better tracking of PICC dwell times, and necessity. Hospitalists may use these data to inform clinical practice, appropriateness, and safety of PICCs in hospitalized patients.
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Affiliation(s)
- Vineet Chopra
- The Division of General Medicine, University of Michigan Health System, Ann Arbor, Michigan
- Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Latoya Kuhn
- Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - David Ratz
- Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Scott A Flanders
- The Division of General Medicine, University of Michigan Health System, Ann Arbor, Michigan
| | - Sarah L Krein
- The Division of General Medicine, University of Michigan Health System, Ann Arbor, Michigan
- Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
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Ferguson C, Inglis SC, Newton PJ, Middleton S, Macdonald PS, Davidson PM. Education and practice gaps on atrial fibrillation and anticoagulation: a survey of cardiovascular nurses. BMC Med Educ 2016; 16:9. [PMID: 26758627 PMCID: PMC4709951 DOI: 10.1186/s12909-015-0504-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 12/07/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Patients' knowledge of their atrial fibrillation (AF) and anticoagulation therapy are determinants of the efficacy of thromboprophylaxis. Nurses may be well placed to provide counselling and education to patients on all aspects of anticoagulation, including self-management. It is important that nurses are well informed to provide optimal education to patients. Current practice and knowledge of cardiovascular nurses on AF and anticoagulation in the Australian and New Zealand (ANZ) context is not well reported. This study aimed to; 1) Explore the nurse's role in clinical decision making in anticoagulation in the setting of AF; 2) Describe perceived barriers and enablers to anticoagulation in AF; 3) Investigate practice patterns in the management of anticoagulation in the ANZ setting; 4) Assess cardiovascular nurses' knowledge of anticoagulation. METHODS A paper-based survey on current practices and knowledge of AF and anticoagulation was distributed during the Australian Cardiovascular Nursing College (ACNC) Annual Scientific Meeting, February 2014. This survey was also emailed to Cardiovascular Trials Nurses throughout New South Wales, Australia and nursing members of the Cardiac Society of Australia and New Zealand (CSANZ). RESULTS There were 41/73 (56%) respondents to the paper-based survey. A further 14 surveys were completed online via nurse members of the CSANZ, and via an investigator developed NSW cardiovascular trials nurse email distribution list. A total of 55 surveys were completed and included in analyses. Prior education levels on AF, stroke risk, anticoagulation and health behaviour modification were mixed. The CHA2DS2VASc and HAS-BLED risk stratification tools were reported to be underused by this group of clinicians. Reported key barriers to anticoagulation included; fears of patients falling, fears of poor adherence to medication taking and routine monitoring. Patient self-monitoring and self-management were reported as underutilised. ANZ cardiovascular nurses reported their key role to be counselling and advising patients on therapy regimens. Anticoagulant-drug interaction knowledge was generally poor. CONCLUSION This study identified poor knowledge and practice in the areas of AF and anticoagulation. There is scope for improvement for cardiovascular nurses in ANZ in relation to AF and anticoagulation knowledge and practice.
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Affiliation(s)
- Caleb Ferguson
- Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Sally C Inglis
- Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Phillip J Newton
- Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Sandy Middleton
- St Vincent's Health Australia (Sydney), Sydney, Australia.
- Australian Catholic University, Sydney, Australia.
| | - Peter S Macdonald
- Heart Transplant Program, Sydney and Victor Chang Cardiac Research Institute, St Vincent's Hospital, Sydney, Australia.
| | - Patricia M Davidson
- Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, Sydney, Australia.
- School of Nursing, Johns Hopkins University, Baltimore, USA.
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Sheppard CE, Then KL, Rankin JA, Appoo JJ. Endovascular Aortic Repair of Primary Adult Coarctation: Implications and Challenges for Postoperative Nursing. Can J Cardiovasc Nurs 2015; 25:5-11. [PMID: 26821453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Endovascular aortic repair is a relatively new surgical technique used to treat a variety of aortic pathologies. Aortic coarctation traditionally has been managed with open surgical repair, involving a large posterolateral thoracotomy, cardiopulmonary bypass, and replacement of the narrowed section of the aorta with a dacron graft. Recent advances in minimally invasive aortic surgery have allowed for repair of the diseased section with an endovascular stent placed percutaneously through the groin under intraoperative fluoroscopic guidance. In this paper, the authors willfocus on the implicationsfor postoperative nursing care after endovascular repair of aortic coarctation using a case study of a 17-year-old male. This novel technique required education of the health care team with respect to implications for practice, understanding potential complications, discharge planning and follow-up. With any new surgical technique there are many questions and challenges that health care professionals raise. The main concerns expressed from the health care team stemmed from a lack of understanding of the disease pathology, and the different risk profile associated with an endovascular repair in contrast to an open repair. The authors will address these concerns in detail.
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Boyne JJJ, Vrijhoef HJM, Spreeuwenberg M, De Weerd G, Kragten J, Gorgels APM. Effects of tailored telemonitoring on heart failure patients' knowledge, self-care, self-efficacy and adherence: a randomized controlled trial. Eur J Cardiovasc Nurs 2013; 13:243-52. [PMID: 23630403 DOI: 10.1177/1474515113487464] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The education of patients with heart failure (HF) is an essential part of disease management. The perspectives of an increasing number of patients and a shortage of professionals force healthcare to explore new strategies in supporting patients to be better informed and more active. METHODS Three hundred and eighty-two patients with HF (age 71±SD 11.2 years) were randomly assigned to either a telemonitoring or a usual care group. Patients received four postal questionnaires to assess their levels of self-reported knowledge, self-care, self-efficacy and adherence. Generalized estimating equations analysis was performed to assess the effects of telemonitoring during the 1-year follow-up. Corrections for baseline were performed if needed. RESULTS Baseline differences between groups were found for self-care (p=0.001) and self-efficacy (p=0.024). Knowledge of patients in the telemonitoring group significantly improved with 0.9 point on a 15-points scale (p<0.001). Their self-care abilities improved with 1.5 point on a 10-item scale whereas no changes were found in patients receiving usual care (p<0.001). Self-efficacy of patients in the intervention group improved significantly after 6 months yet was not significantly different after 3 months and 1 year. For patients in the intervention group adherence improved for daily weighing (p<0.001) during the whole follow-up and for fluid intake (p=0.019) after 3 months and after 12 months (p=0.086). Adherence for activity recommendations improved (p=0.023) after 3 months and importance of medication adherence increased after 6 (p=0.012) and 12 months (p=0.037). No effects were found regarding appointments, diet, smoking and use of alcohol. CONCLUSIONS Tailored telemonitoring was found to educate patients with HF and to improve their self-care abilities and sense of self-efficacy.
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Affiliation(s)
- Josiane J J Boyne
- 1Department of Patient and Care, Maastricht University Medical Centre, and CAPHRI, Department of Health Services Research, Maastricht University, The Netherlands
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