scholarly journals P134: Organizational interventions and policies to support second victims in acute care settings: a scoping study

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S112-S113
Author(s):  
L. Wade ◽  
N. Williams ◽  
E. Fitzpatrick ◽  
R. Parker ◽  
K. Hurley
Keyword(s):  
Acute Care ◽  
Peer Support ◽  
Program Effectiveness ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Scoping Study ◽  
Second Victim ◽  
Non Accidental Trauma ◽  
Acute Care Settings ◽  
Definition Of

Introduction: The harm that may come to healthcare providers impacted by adverse events has led them to be called “second victims.” Our objective was to characterize the range and context of interventions used to support second victims in acute care settings. Methods: We performed a scoping study using the process described by Arksey and O'Malley. Comprehensive searches of scientific databases and grey literature were conducted in September 2017 and updated in November 2018. A library scientist searched PubMed, CINAHL, EMBASE and CENTRAL. We sought unpublished literature (Canadian Electronic Library, Proquest and Scopus) and searched reference lists of included studies. Stakeholder organizations and authors of included studies were contacted through email, requesting information on relevant programs. Two reviewers independently reviewed titles and abstracts using predetermined criteria. Using a structured data abstraction form, two reviewers independently extracted data and appraised methodological quality with the Mixed Methods Appraisal Tool (MMAT). All discrepancies were resolved through consensus. A qualitative approach was used to categorize the context and characteristics of the identified strategies and interventions. Results: Our search strategy yielded 3883 results. After screening titles and abstracts, 173 studies underwent full text screening. Extracted data reflected 21 interventions categorized as providing peer-support (n = 7), proactive education (n = 7) or both (n = 7). Programs came from Canada (n = 2), Spain (n = 2), and United States (n = 17). Specific traumatic events were described as the trigger for development of five programs. While some programs were confined to a standard definition of second victim as a healthcare provider traumatized by an “unanticipated adverse patient event” (n = 6), other programs had a broader scope (n = 12) including situations such as non-accidental trauma, stressful anticipated patient events and complaints/litigation (3 programs were unclear about the definition). Confidentiality was assured in nine peer support programs. Outcome measures were often not reported and were limited in terms of quality. Conclusion: This is a new area of study with little scientific rigour from which to determine whether these programs are effective. Concerns about protecting healthcare providers from potential legal proceedings hinder documentation and study of program effectiveness.

scholarly journals VP199 Limitations Of Studies On Oxygen Therapy In Acute Care Settings

2017 ◽  
Vol 33 (S1) ◽  
pp. 242-243
Author(s):  
Carmen Moga ◽  
Dagmara Chojecki
Keyword(s):  
Acute Care ◽  
Oxygen Therapy ◽  
A Priori ◽  
Healthcare Providers ◽  
Rapid Review ◽  
General Tendency ◽  
Qualitative Synthesis ◽  
Design Data ◽  
Safety Issues ◽  
Acute Care Settings

INTRODUCTION:A high-level, rapid review (1) was conducted on oxygen therapy issues studied in the past 10 years in acute care settings. The main objective was to determine the appropriateness/inappropriateness of use, safety issues, and quality of care associated with oxygen prescription, administration, and monitoring. The results from this review were used to inform an upcoming provincial oxygen summit.METHODS:The Health Technology Assessment review (1) used a standardized rapid review approach: a comprehensive search of literature (published in English from 2005 to 2016), study selection using a priori developed criteria, and a qualitative synthesis of the results. Iterative interactions with the requester were necessary to clarify and refine the research questions, scope, and inclusion criteria.RESULTS:Twenty-four audit studies were reviewed, the majority published after 2011, in the United Kingdom, and also in single institutions. Twelve studies reported effects after implementing interventions for improvement of oxygen prescription. Many studies had caveats on design, data reporting, and outcomes, or they lacked an explanation of the methods of analysis. Studies conducted in rural settings, and on infants and children were unavailable. The reported issues with oxygen therapy included: a lack or an inconsistency of compliance with guidelines, local policies, and standards; inappropriate prescription and administration; variability in practice among healthcare providers; and suboptimal monitoring, including poor standards of medical chart documentation for patients receiving oxygen therapy, such as incomplete details on flow rate and oxygen concentration.CONCLUSIONS:Possibly due to the general tendency to publish research findings that have statistically significant results, relatively few publications were found in the literature search. The universal use of oxygen therapy and the enrolment of consecutive patients in some of the studies increase the applicability of the findings to other institutions. The rapid review provided a timely synthesis of the available, credible research for use by local stakeholders for further discussions and planning.

scholarly journals User-centered design of a longitudinal care plan for children with medical complexity

2020 ◽  
Vol 27 (12) ◽  
pp. 1860-1870
Author(s):  
Arti D Desai ◽  
Grace Wang ◽  
Julia Wignall ◽  
Dylan Kinard ◽  
Vidhi Singh ◽  
...  
Keyword(s):  
Acute Care ◽  
Information Needs ◽  
Healthcare Providers ◽  
Care Plan ◽  
User Centered Design ◽  
Children With Medical Complexity ◽  
Medical Complexity ◽  
Care Coordinators ◽  
Acute Care Settings ◽  
Design Preferences

Abstract Objective To determine the content priorities and design preferences for a longitudinal care plan (LCP) among caregivers and healthcare providers who care for children with medical complexity (CMC) in acute care settings. Materials and Methods We conducted iterative one-on-one design sessions with CMC caregivers (ie, parents/legal guardians) and providers from 5 groups: complex care, primary care, subspecialists, emergency care, and care coordinators. Audio-recorded sessions included content categorization activities, drawing exercises, and scenario-based testing of an electronic LCP prototype. We applied inductive content analysis of session materials to elicit content priorities and design preferences between sessions. Analysis informed iterative prototype revisions. Results We conducted 30 design sessions (10 with caregivers, 20 with providers). Caregivers expressed high within-group variability in their content priorities compared to provider groups. Emergency providers had the most unique content priorities among clinicians. We identified 6 key design preferences: a familiar yet customizable layout, a problem-based organization schema, linked content between sections, a table layout for most sections, a balance between unstructured and structured data fields, and use of family-centered terminology. Discussion Findings from this study will inform enhancements of electronic health record-embedded LCPs and the development of new LCP tools and applications. The design preferences we identified provide a framework for optimizing integration of family and provider content priorities while maintaining a user-tailored experience. Conclusion Health information platforms that incorporate these design preferences into electronic LCPs will help meet the information needs of caregivers and providers caring for CMC in acute care settings.

scholarly journals Peer support programs for people experiencing suicidality – A systematic scoping review of current literature

2019 ◽  
Author(s):  
MARISA SCHLICHTHORST ◽  
Ingrid Ozols ◽  
Lennart Reifels ◽  
Amy Morgan
Keyword(s):  
Peer Support ◽  
Suicide Prevention ◽  
Scoping Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Mental Healthcare ◽  
Support Programs ◽  
Research Knowledge ◽  
Definition Of ◽  
Clinical Trials Registry

Abstract Background Peer-led support models have gained increasing popularity in mental healthcare. Yet little is known about the types of peer support programs that exist in suicide prevention and whether these are effective in improving the health and wellbeing of people at risk of suicide.Method We conducted a systematic scoping review, involving a search of three academic (Medline, PsycINFO, Embase), and selected grey literature databases (Google Scholar, WHO Clinical Trials Registry) for publications between 2000 and 2019. We also contacted suicide prevention experts and relevant internet sites to identify peer support programs that exist but have not been evaluated. The screening of records followed a systematic two-stage process in alignment with PRISMA guidelines.Results We identified 8 records accounting for 7 programs focused on peer-led support programs in suicide prevention. These programs employed a range of different designs and included a variety of settings (schools, communities, rural and online). Only 4 of these 7 programs contained data on the effectiveness of the program, and this evaluation data was descriptive on all accounts but showed promising results. With the small number of eligible programs in this review our findings are limited and must be interpreted with caution.Conclusions Despite the increased focus of policymakers on the importance of peer support programs in suicide prevention, our scoping review confirms an evidence gap in research knowledge regarding design, implementation, and effectiveness of programs. More rigour is required in reporting peer support initiatives to clarify the underlying definition of peer support and to enhance our understanding of the types of current peer support programs available to those experiencing suicidality. Further, we need formal and high-quality evaluations of peer support suicide prevention programs to better understand their effectiveness on participant health across different settings and delivery modalities and to allow for comprehensive systematic reviews and meta-analysis in future.

scholarly journals Interventions to Reduce Benzodiazepine and Sedative-Hypnotic Drug Use in Acute Care Hospitals: A Scoping Review

2020 ◽  
Author(s):  
Heather L Neville ◽  
Courtney Granter ◽  
Pegah Adibi ◽  
Julia Belliveau ◽  
Jennifer E Isenor ◽  
...  
Keyword(s):  
Acute Care ◽  
Scoping Review ◽  
Relaxation Training ◽  
Care Setting ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Acute Care Setting ◽  
Stakeholder Consultation ◽  
Behavior Change Interventions ◽  
Hospital Patients

Abstract Background Benzodiazepines and sedative-hypnotics (BZD/SHD) are commonly utilized in the acute care setting for insomnia and anxiety and are associated with cognitive impairment, falls, fractures, and increased mortality. Interventions to reduce use of BZD/SHD in hospitals are not well characterized. The objective of the scoping review was to identify and characterize interventions to reduce the use of BZD/SHD by adults for anxiety and sedation in hospitals.Methods We included studies and abstracts published in English that described an intervention to reduce BZD/SHD in adult hospital patients. Six databases (PubMed, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science) and the grey literature (Opengrey, Grey Matters, Google Advanced) were searched up to July 2018. Titles and abstracts were screened and full-text articles were reviewed for potential inclusion by three independent reviewers. Data on each eligible study was charted in a Microsoft Excel® database. Stakeholder consultation occurred before and after the scoping review was completed. Results There were 9480 records identified from all sources and 35 studies were included in the scoping review. Included studies were divided into two categories that emerged from stakeholder feedback: sedatives prescribed in hospital or home medications. The most common study designs were pre-/post-test (24, 68.6%) and randomized controlled trials (6, 17.1%). The majority of studies tested a single intervention (28, 80%) and these were most commonly education, relaxation training and sleep protocols. Patients were frequently the target of relaxation training and behavior change interventions, while sleep protocols, multifaceted interventions and education were usually directed at healthcare providers, either alone or in combination with patients. Most studies reported positive outcomes in decreasing BZD/SHD use (23, 65.7%), including some that were statistically significant (13, 37.1%). Conclusions This scoping review found a variety of interventions aimed at decreasing the utilization of BZD/SHD in the acute care setting, where previously little was known. Current literature addressed the initiation of BZD/SHD in hospital, rather than chronic medications that had been prescribed in the community. Stakeholder consultation supported these findings and pointed out important factors to consider when designing an intervention for hospital patients. Registration: Open Science Framework, https://osf.io/u7s4h/?view_only=15a9b9134be743b6a4177ba2eec9e91a

scholarly journals Optimising expert dyad performance in acute care settings: a scoping review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e047260
Author(s):  
Katie Walker ◽  
Maryam Asoodar ◽  
Jenny Rudolph ◽  
Michael Meguerdichian ◽  
Tricia Yusaf ◽  
...  
Keyword(s):  
Acute Care ◽  
Research Policy ◽  
Grey Literature ◽  
Future Research ◽  
City Hospital ◽  
Excellent Performance ◽  
Hospital System ◽  
Learning Practices ◽  
Scoping Reviews ◽  
Acute Care Settings

IntroductionWhen there is miscommunication and poor coordination between experienced clinician dyads, teamwork suffers. Research on expert learning practices for the smallest team, and arguably the most important team, the healthcare dyad, is limited. The objective of this study is to map the extent and range of evidence available on learning practices which experienced dyads use, to achieve excellent performance, and to identify the gaps in effective practice. This will guide future research, policy and practice.Methods and analysisWe are using the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews Extension Fillable Checklist, searching for literature that meets the inclusion criteria. The searches will be conducted using Maastricht University’s Libsearch, which includes MEDLINE, Education Resources Information Center and PsycINFO and a second search on Web of Science online databases. We will search grey literature and references of selected sources. Search limits include sources from 2016 to 2021, using English language only. A data extraction tool was developed, and charting will use a thematic analysis approach.Implications and disseminationThis review will be the first to examine the learning practices that experienced dyads use, which ensures excellent performance in acute care settings. The findings will be used to develop best-practices and shared with New York City hospital system. Dissemination will occur through peer-reviewed publications and at healthcare conferences.

Improving Patient Safety and Patient–Provider Communication

2019 ◽  
Vol 4 (5) ◽  
pp. 1017-1027 ◽  
Author(s):  
Richard R. Hurtig ◽  
Rebecca M. Alper ◽  
Karen N. T. Bryant ◽  
Krista R. Davidson ◽  
Chelsea Bilskemper
Keyword(s):  
Acute Care ◽  
Augmentative And Alternative Communication ◽  
Health Care Team ◽  
Provider Communication ◽  
Alternative Communication ◽  
Patient Provider Communication ◽  
Acute Care Settings ◽  
Nurses Perceptions ◽  
Communication Needs ◽  
The Impact

Purpose Many hospitalized patients experience barriers to effective patient–provider communication that can negatively impact their care. These barriers include difficulty physically accessing the nurse call system, communicating about pain and other needs, or both. For many patients, these barriers are a result of their admitting condition and not of an underlying chronic disability. Speech-language pathologists have begun to address patients' short-term communication needs with an array of augmentative and alternative communication (AAC) strategies. Method This study used a between-groups experimental design to evaluate the impact of providing patients with AAC systems so that they could summon help and communicate with their nurses. The study examined patients' and nurses' perceptions of the patients' ability to summon help and effectively communicate with caregivers. Results Patients who could summon their nurses and effectively communicate—with or without AAC—had significantly more favorable perceptions than those who could not. Conclusions This study suggests that AAC can be successfully used in acute care settings to help patients overcome access and communication barriers. Working with other members of the health care team is essential to building a “culture of communication” in acute care settings. Supplemental Material https://doi.org/10.23641/asha.9990962

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