Envisioning successful teamwork: An exploratory qualitative study of team processes used by nursing teams in a paediatric hospital unit

2018 ◽  
Vol 27 (23-24) ◽  
pp. 4257-4269
Author(s):  
Leeann Whitehair ◽  
John Hurley ◽  
Steve Provost
Keyword(s):  
Qualitative Study ◽  
Team Processes ◽  
Hospital Unit ◽  
Paediatric Hospital ◽  
Nursing Teams

scholarly journals Barriers to Physical Distancing among Healthcare Workers on an Academic Hospital Unit During the COVID-19 Pandemic

2021 ◽  
pp. 1-26
Author(s):  
Sara C. Keller ◽  
Sara Pau ◽  
Alejandra B. Salinas ◽  
Opeyemi Oladapo-Shittu ◽  
Sara E. Cosgrove ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Workers ◽  
Tertiary Hospital ◽  
Peer Leaders ◽  
Human Factors Engineering ◽  
Structured Interviews ◽  
Hospital Unit ◽  
Positive Behaviors ◽  
Cognitive Aids ◽  
Close Proximity

Abstract Background: Physical distancing among healthcare workers (HCW) is an essential strategy in preventing HCW-to-HCW transmission of the SARS-CoV-2 virus. Objective: To understand barriers to physical distancing among HCW on an inpatient unit and identify strategies for improvement. Design: Qualitative study including observations and semi-structured interviews over three months. Setting: A non-COVID adult general medical unit in an academic tertiary hospital. Participants: HCWs based on the unit. Methods: We performed a qualitative study in which we (1) observed HCWs activities and proximity to each other on the unit during weekday shifts July-October 2020 and (2) conducted semi-structured interviews of HCWs to understand their experiences with and perspectives of physical distancing in the hospital. Qualitative data were coded based on a human factors engineering model. Results: We completed 25 hours of observations and 20 HCW interviews. High-risk interactions often occurred during handoffs of care at shift changes and patient rounds, where HCWs gathered regularly in close proximity for at least 15 minutes. Identified barriers included spacing and availability of computers, the need to communicate confidential patient information, and the desire to maintain relationships at work. Conclusions: Physical distancing can be improved in hospitals by restructuring computer workstations, work rooms, and breakrooms; applying visible cognitive aids; adapting shift times; and supporting rounds and meetings with virtual conferencing. Additional strategies to promote staff adherence to physical distancing include rewarding positive behaviors, having peer leaders model physical distancing, and encouraging additional safe avenues for social connection at a safe distance.

scholarly journals The surgical journey: exploring the OR-PACU handover

2021 ◽  
Author(s):  
Marketa Gross
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Content Analysis ◽  
Qualitative Study ◽  
Adverse Events ◽  
Team Processes ◽  
Team Members ◽  
Handover Process ◽  
Collective Competence ◽  
Transfer Of Information

Patient safety in health care remains a serious concern in Canada. Adverse events can lead to physiological and psychological complications and pose a significant economic burden on the health care system. The purpose of this descriptive qualitative study was to explore the team processes, roles and factors that underpin effective communication between team members during an OR-PACU handover. Content analysis revealed four major categories: Ownership, Distractions and Interruptions, Transfer of Information and Workflow. The results of this study, informed by the Theory of Collective Competence enhance our understanding of the OR-PACU handover and support the need for the development of a structured OR-PACU team handover process.

scholarly journals Nurses’ Experiences of Blood Sample Collection from Children: A Qualitative Study from Swedish Paediatric Hospital Care

2021 ◽  
Author(s):  
Henrik Hjelmgren ◽  
Britt-Marie Ygge ◽  
Björn Nordlund ◽  
Nina Andersson
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Blood Sample ◽  
Hospital Care ◽  
Blood Sampling ◽  
Sample Collection ◽  
Focus Group Interviews ◽  
Paediatric Hospital ◽  
Group Interviews ◽  
Analytical Errors

Abstract Background: Blood sampling collections are necessary and important for diagnosis and treatment in paediatric hospital care. Nurses play an active role in helping the children with the blood sampling experience. Unfortunately, the blood sampling collection procedure is often affected by pre-analytical errors, leading to consequences such as delayed diagnosis, treatment and hospital stay, as well as repeated sampling. Moreover, children state that needle procedures are the worst experience of their hospital stay. Nurses working in children’s hospitals are responsible for conducting most of the needle related procedures but their experience of errors occurring during blood sample collection is unknown. The aim of this study therefore was to describe paediatric nurses’ experiences of blood sampling collections from children. Method: We used a qualitative study design with a (reflexive) thematic analysis (TA) method. Three focus group interviews were conducted, with 19 nurses from Sweden working at two different paediatric hospitals, focusing on their experiences of the blood sample collection procedure. Results: From the three focus group interviews we analysed patterns and meanings of the following themes: Paediatric blood sampling is a challenge for the nurses, Nurses’ feelings of frustration with unsuccessful samplings, Nurses believe in team work, Venous blood sampling was experienced as the best option, and Nurses’ thoughts and needs regarding skills development in paediatric blood sampling. Conclusion: The narrative results of this study illustrate that nurses working in paediatric hospital care face a big challenge in blood sampling collection from children. The nurses felt frustrated due to unsuccessful blood samplings and frequently could not understand why pre-analytical errors occurred. Nevertheless, they felt strengthened by colleagues in their team and shared feelings of responsibility to help each other with this complex procedure. The implications of this study are that paediatric hospital care needs to focus on improving guidelines for and increasing competence in blood sampling children and helping nurses to understand why samplings may be unsuccessful and how this can be avoided.

scholarly journals A educação permanente e as práticas em saúde: concepções de uma equipe multiprofissional

2019 ◽  
Vol 7 (14) ◽  
pp. 230
Author(s):  
Márcia Parente Silva Lamante ◽  
Mara Quaglio Chirelli ◽  
Danielle Abdel Massih Pio ◽  
Silvia Franco da Rocha Tonhom ◽  
Maria Cristina Martinez Capel ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Health Planning ◽  
Health Practices ◽  
Multiprofessional Team ◽  
Hospital Unit ◽  
Health Training ◽  
Before And After ◽  
Three Stages

Resumo: A Educação Permanente em Saúde (EPS) reconhece que é possível por meio de um processo reflexivo, o cuidado integral e humanizado. O objetivo deste estudo foi analisar como uma estratégia de EPS mobilizou a prática da equipe multiprofissional em uma unidade hospitalar. Estudo qualitativo, composto por três etapas: dois grupos focais, realizados de forma prévia e posterior à intervenção subsidiada pelo Planejamento Estratégico Situacional. Utilizou-se como referencial metodológico, o Discurso do Sujeito Coletivo. Nos resultados verificou-se ganho de conhecimentos, novas habilidades e atitudes exploradas a partir da subjetividade dos encontros. Mudanças aconteceram com relação à identificação da potencialidade da EPS, seus alcances e efetividade como ferramenta de gestão e de construção de uma práxis. A organização desta proposta pode ser motivadora para a realização de EPS em outros espaços, por permitir a grupalidade e a cogestão de processos de trabalho.Palavras-chave: Educação Permanente em Saúde; Integralidade em saúde; Capacitação em Serviço; Planejamento em Saúde. Permanent education and the health practices: perceptions of the multiprofessional-teamAbstract: The Permanent Education in Health (PEH) recognizes that it is possible through a reflexive process, the integral and humanized care. The objective of this study was to analyze how a strategy of PEH mobilized the practice of the multiprofessional team in a hospital unit. Qualitative study, composed of three stages: two focus groups, carried out before and after the intervention subsidized by the Strategic Situational Planning. The Collective Subject Discourse was used as methodological reference. In the results it was verified gain of knowledge, new abilities and attitudes explored from the subjectivity of the meetings. Changes occurred in relation to the identification of the potentiality of EPS, its scope and effectiveness as a tool for management and construction of a praxis. The organization of this proposal can be motivating for the execution of EPS in other spaces, because it allows grouping and co-management of work processes.Keywords: Permanent Education in Health; Integrality in health; Training in Service; Health Planning. 

scholarly journals Analyzing the Barriers to Knowledge Distribution in Hospital Managers A qualitative study in educational hospitals in Shiraz and Kerman

2019 ◽  
Author(s):  
Moslem Heydaripur ◽  
Abbas Yazdanpanah ◽  
Amin Torabi pur
Keyword(s):  
Qualitative Study ◽  
Cultural Barriers ◽  
Knowledge Dissemination ◽  
Step Method ◽  
Statistical Population ◽  
Team Processes ◽  
Hospital Managers ◽  
The Media ◽  
Level Of Knowledge

Introduction: Hospital managers routinely make complex and important for the health of their Society.The quality of these decisions depends on the amount of information, experience and knowledge of the managers. This study aimed to identify barriers to the  knowledge sharing among managers  of educational hospitals in the south-east of the country. Method: This is a qualitative study that was done using the phenomenological method. The research community was composed of all managers of selected educational hospitals in Fars and Kerman provinces. The research sample was selected through in-sample sampling and among managers who were somehow involved in the dissemination of knowledge. The total number of statistical population consisted of 40 hospital managers, with 26 of these semi-structured interviewers. Sampling was carried out to the extent that the data from 26 interviews reached the saturation level, then the results were analyzed using a seven-step method. Results: The results of this study showed that the main barriers to knowledge dissemination among hospital managers in seven main sections, each in subcategories including: cultural barriers in 9 sub categories, financial facilities in 2 sub categories, development and promotion of education in 13 sub categories , Policies, rules and regulations in 9 sub-categories, communications in 8 sub-categories, human resources in 9 sub-categories, and management policies in 10 sub-categories. Conclusion: Knowledge dissemination among managers is essential in order to increase their level of knowledge and their ability to make better decisions. With the importance of proper education, the culture of studying and the transfer of experience and knowledge in hospitals and universities, the culture of collaborative learning is institutionalized. Review some of the laws of the media to support managers and their job stability and their educational policies, and increase the quality of education in universities. Managers use appropriate methods and communication skills and have individual and organizational interactions. Due diligence and attention to the ability of managers, proper information and managers' moves towards collaborative and team processes can remove barriers to knowledge dissemination

scholarly journals Electronic ordering and the management of treatment interdependencies: a qualitative study of paediatric chemotherapy

2020 ◽  
Author(s):  
Valentina Lichtner ◽  
Bryony Dean Franklin ◽  
Luciano Dalla-Pozza ◽  
Johanna I Westbrook
Keyword(s):  
Qualitative Study ◽  
High Reliability ◽  
Patient Treatment ◽  
Structured Interviews ◽  
Computerized Provider Order Entry ◽  
Team Members ◽  
Paediatric Hospital ◽  
Use Of Time ◽  
Safety Risks ◽  
Safety Models

Abstract Background: There are serious safety risks associated with chemotherapy, often associated with interdependencies in regimens administered over months or years. Various strategies are used to manage these risks. Computerized provider order entry (CPOE) systems are also implemented to improve medication safety. Little is known regarding the effect of CPOE on how clinicians manage chemotherapy interdependencies and their associated safety strategies.Methods: We conducted a multi-method qualitative study in a paediatric hospital. We analysed 827 oncology incidents reported following CPOE implementation and carried out semi-structured interviews with doctors (n=10), nurses (n=6), a pharmacist, and oncology CPOE team members (n=2). Results were interpreted according to safety models (ultra-safe, high-reliability organisations [HROs], or ultra-adaptive). Results: Incident reports highlighted two interrelated types of interdependencies: those within organisation of clinical activities and those inherent in chemotherapy regimens. Clinicians reported strategies to address chemotherapy risks and interdependencies. These included rigid rules and ‘no go’ contexts for treatment to proceed, typical of the ultra-safe model; use of time (e.g. planning only so far ahead) and sensitivity to operations, typical of HROs. We identified three different time horizons in CPOE use in relation to patients’ treatments: life-long, the whole regimen, and the ‘here and now’. CPOE supported ultra-safe strategies through automation and access to rules/standardisation, but also created difficulties and contributed to incidents. It supported the ‘here and now’ better than a life-long or whole regimen view of a patient treatment. Sensitivity to operations was essential to anticipate and resolve uncertainties, hazards, CPOE limitations, and mismatches between CPOE processes and workflow in practice. Conclusions: Within oncology, CPOE appears to move the ‘mix’ of risk strategies towards ultra-safe models of safety and protocol-mandated care. However, in order to operate ultra-safe strategies embedded in CPOE and stay on protocol it is essential for clinicians to be thoughtful and show sensitivity to operations in CPOE use. CPOE design can be advanced by better consideration of mechanisms to support interdependencies.

scholarly journals Conforto nos momentos finais da vida: a percepção da equipe multidisciplinar sobre cuidados paliativos [Comfort in the last moments of life: the multidisciplinary team's perception on palliative care] [Confort en los momentos finales de la vida: la percepción del equipo multidisciplinaria en cuidados paliativos]

2019 ◽  
Vol 27 ◽  
pp. e45135
Author(s):  
Antonio Ribeiro Silva ◽  
Thereza Maria Magalhães ◽  
Raquel Sampaio Florencio ◽  
Lorena Campos Souza ◽  
Amanda Caboclo Flor ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Multidisciplinary Team ◽  
Northeastern Brazil ◽  
Care Practice ◽  
Structured Interviews ◽  
Hospital Unit ◽  
Descriptive Qualitative

Objetivo: analisar a percepção dos profissionais da equipe multidisciplinar acerca da assistência em cuidados paliativos. Método: estudo descritivo, qualitativo, desenvolvido em outubro de 2017, em hospital especializado em doenças cardiopulmonares situado em uma capital do nordeste brasileiro. O projeto do estudo foi aprovado por Comitê de Ética em Pesquisa. A amostra contou com 15 participantes da equipe multidisciplinar. Os dados foram coletados mediante entrevista semiestruturada e submetidos à análise temática. Resultados: da análise, emergiram duas categorias: conhecimento da equipe multidisciplinar sobre cuidados paliativos e a percepção da prática dos cuidados paliativos. Os profissionais possuem um conhecimento ainda incipiente sobre cuidados paliativos e suas prerrogativas, além da necessidade de um comprometimento efetivo para a qualidade desse cuidado. Conclusão: apesar de os profissionais reconhecerem a necessidade de oferecer conforto nos momentos finais da vida, o conhecimento acerca do cuidado paliativo é limitado e, por isso, eles vivenciam dilemas ao lidar com equipes, pacientes e familiares.ABSTRACTObjective: to analyze the perception of professionals of the multidisciplinary team about assistance in palliative care. Method: descriptive, qualitative study, developed in October 2017 in a hospital unit specialized in cardiopulmonary diseases located in a capital of Northeastern Brazil. The sample included 15 participants from the multidisciplinary team. Data were collected through semi-structured interviews and submitted to thematic analysis. Results: from the analysis, two categories emerged: knowledge of the multidisciplinary team on palliative care and the perception of palliative care practice. The professionals have a still incipient knowledge about what palliative care is and its prerogatives, in addition to the need for an effective commitment to the quality of this care. Conclusion: Although professionals recognize the need to offer comfort in the final moments of life, knowledge about palliative care is limited and, therefore, professionals perceive dilemmas when dealing with staff, patient and family.RESUMENObjetivo: analizar la percepción de los profesionales del equipo multidisciplinario sobre la asistencia en cuidados paliativos. Método: estudio descriptivo, cualitativo, desarrollado en octubre de 2017 en una unidad hospitalaria especializada en enfermedades cardiopulmonares ubicada en una capital del noreste de Brasil. La muestra incluyó a 15 participantes del equipo multidisciplinario. Los datos fueron recolectados a través de entrevistas semiestructuradas y sometidos a análisis temático. Resultados: del análisis surgieron dos categorías: conocimiento del equipo multidisciplinario sobre cuidados paliativos y la percepción de la práctica de cuidados paliativos. Los profesionales tienen un conocimiento aún incipiente sobre qué son los cuidados paliativos y sus prerrogativas, además de la necesidad de un compromiso efectivo con la calidad de esta atención. Conclusión: aunque los profesionales reconocen la necesidad de ofrecer comodidad en los momentos finales de la vida, el conocimiento sobre los cuidados paliativos es limitado y, por lo tanto, los profesionales perciben dilemas al tratar con el personal, el paciente y la familia.

scholarly journals The surgical journey: exploring the OR-PACU handover

2021 ◽  
Author(s):  
Marketa Gross
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Content Analysis ◽  
Qualitative Study ◽  
Adverse Events ◽  
Team Processes ◽  
Team Members ◽  
Handover Process ◽  
Collective Competence ◽  
Transfer Of Information

Patient safety in health care remains a serious concern in Canada. Adverse events can lead to physiological and psychological complications and pose a significant economic burden on the health care system. The purpose of this descriptive qualitative study was to explore the team processes, roles and factors that underpin effective communication between team members during an OR-PACU handover. Content analysis revealed four major categories: Ownership, Distractions and Interruptions, Transfer of Information and Workflow. The results of this study, informed by the Theory of Collective Competence enhance our understanding of the OR-PACU handover and support the need for the development of a structured OR-PACU team handover process.

scholarly journals Electronic ordering and the management of treatment interdependencies: a qualitative study of paediatric chemotherapy

2020 ◽  
Author(s):  
Valentina Lichtner ◽  
Bryony Dean Franklin ◽  
Luciano Dalla-Pozza ◽  
Johanna I Westbrook
Keyword(s):  
Qualitative Study ◽  
High Reliability ◽  
Structured Interviews ◽  
Computerized Provider Order Entry ◽  
Team Members ◽  
Paediatric Hospital ◽  
Use Of Time ◽  
Safety Risks ◽  
Incident Reports ◽  
Safety Models

Abstract Background There are serious safety risks associated with chemotherapy, often associated with interdependencies in regimens administered over months or years. Various strategies are used to manage these risks. Computerized provider order entry (CPOE) systems are also implemented to improve medication safety. Little is known regarding the effect of CPOE on how clinicians manage chemotherapy interdependencies and their associated safety strategies. Methods We conducted a multi-method qualitative study in a paediatric hospital. We analysed 827 oncology incidents reported following CPOE implementation and carried out semi-structured interviews with doctors (n = 10), nurses (n = 6), a pharmacist, and oncology CPOE team members (n = 2). Results were interpreted according to safety models (ultra-safe, high-reliability organisations [HROs], or ultra-adaptive). Results Incident reports highlighted two interrelated types of interdependencies: those within organisation of clinical activities and those inherent in chemotherapy regimens. Clinicians reported strategies to address chemotherapy risks and interdependencies. These included rigid rules and ‘no go’ contexts for treatment to proceed, typical of the ultra-safe model; use of time (e.g. planning only so far ahead) and sensitivity to operations, typical of HROs. CPOE supported ultra-safe strategies through automation and access to rules/standardisation. However, sensitivity to operations was needed to anticipate and resolve uncertainties, hazards, CPOE limitations, and mismatches between CPOE processes and workflow in practice. Conclusions Within oncology, CPOE appears to move the ‘mix’ of risk strategies towards ultra-safe models of safety and protocol-mandated care. However, operating ultra-safe strategies embedded in CPOE and staying on protocol necessitate sensitivity to operations in CPOE use. CPOE design can be advanced by better consideration of mechanisms to support interdependencies.

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