scholarly journals Identification of Barriers to SBARB at the Bedside in an Acute Care Setting

2018 ◽  
Author(s):  
Elizabeth Bryand
Keyword(s):  
Patient Safety ◽  
Acute Care ◽  
Care Setting ◽  
Healthcare Providers ◽  
Staff Nurses ◽  
Practice Change ◽  
Perceived Barriers ◽  
Sensitive Information ◽  
Acute Care Setting ◽  
Patient Privacy

Nurse to nurse handoff that occurs at the end of each shift is a known area of potential safety risk due to poor communication and inadequate safety checks. The Joint Commission (TJC) reported that communication between healthcare providers or between patient and healthcare providers was the leading root cause of sentinel events. Research supports the benefits of a structure handoff at the bedside to patient safety and satisfaction. Despite these proven benefits, staff nurses have not consistently embraced the practice. The purpose of this study was to identify nurses’ perceived barriers to performing SBARP (Situation, Background, Assessment, Recommendation and Patient) at the bedside in an acute care setting. Rogers Diffusion of Innovation Theory was used to guide the development and implementation of this project. A mixed qualitative and quantitative survey was utilized to assess the nurses’ perceived barriers to performing SBARP at the patient’s bedside. The survey was distributed to nurses employed on two medical-surgical floors at Newport Hospital. Responses (N = 19) showed that although staff nurses perceived that bedside handoff positively impacted patient satisfaction and patient safety, they did not routinely practice bedside handoff. Nurses cited lack of comfort with the practice, patient privacy, perception of time, and communication of sensitive information as barriers to performing bedside handoff. Sustaining practice change over time in an organization can be challenging. Leadership support and enforcement of bedside handoff in addition to targeted education to reduce perceived barriers to the practice may help to increase the practice of bedside handoff.

A conceptual framework identifying sources of risk to patient safety in primary care

2012 ◽  
Vol 18 (3) ◽  
pp. 185 ◽  
Author(s):  
Logan McLeod ◽  
JoAnn Kingston-Riechers ◽  
Egon Jonsson
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Acute Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Care Delivery ◽  
Acute Care Setting ◽  
Primary Care Delivery ◽  
Potential Risks ◽  
Organisational Structures

The potential risks to patient safety in a primary care setting are different than the risks to patient safety in an acute care setting. The main differences arise from the organisational structures of primary care delivery and the greater involvement of patients in their care. To account for these differences, we present the Patient Safety in Primary Care Framework to conceptualise the sources of risk to patient safety.

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 Point-of-care ultrasonography: training, applications and barriers. A survey study

2019 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
Gentle S. Shrestha ◽  
Subhash P. Acharya ◽  
Pramesh S. Shrestha ◽  
Ninadini Shrestha ◽  
Hem R. Paneru ◽  
...  
Keyword(s):  
Acute Care ◽  
Care Setting ◽  
Point Of Care ◽  
Daily Practice ◽  
Perceived Barriers ◽  
Survey Study ◽  
Point Of Care Ultrasound ◽  
Acute Care Setting ◽  
Ultrasound Machine ◽  
Effective Use

Background and Aims: Use of point-of-care ultrasound (POCUS) in acute care setting has rapidly increased and has potentials to guide patient management. This survey study aims to explore the usefulness of a one-day workshop and to elicit the perceived barriers for effective use of POCUS. Methods: A total of 169 doctors who had attended one day Acute Care Ultrasound workshop were approached through email. Online link to access the survey created using Google forms was sent. The survey contained questions related to the details about the participants, feedback about the workshop, whether the workshop has helped to change the practice of the participants, availability of ultrasound machine during the daily practice and the perceived barriers for use of POCUS. Results: A total of 41 responses were obtained. Majority of the participants had anaesthesiology as the base specialty followed by general practice. Most of them had ICU as their predominant working place, followed by emergency room and operating room. The workshop was found to be helpful by most of the participants. Majority of the participants (20 participants; 49%) had ultrasound machine sometimes available during their daily practice. Only 20% (8 participants) had ultrasound machine always available during their clinical practice. Similarly, 46% (19 participants) considered lack of access to ultrasound machine as a barrier for application of POCUS. Significant number of participants considered lack of supervision and guidance (18 participants; 44%) and lack of knowledge and skills (13 participants; 32%) as the barriers. Conclusions: Majority of the participants found the one-day workshop helpful. Doctors from various specialty, working in acute care setting had participated in the survey. Limited access to ultrasound machine, together with lack of adequate knowledge and skills were perceived as major barriers for effective use of point-of-care ultrasound.

scholarly journals Experiences of nurses implementing evidence-based practice in an acute care setting in Nigeria: A qualitative study

2019 ◽  
Vol 7 (4) ◽  
pp. 54
Author(s):  
Jude N. Ominyi ◽  
David A. Agom ◽  
Chukwuma N. Anyigor ◽  
Aaron B. Nwedu ◽  
Simon N. Onwe
Keyword(s):  
Acute Care ◽  
Care Setting ◽  
Nurse Managers ◽  
Evidence Based Practice ◽  
Staff Nurses ◽  
Evidence Based ◽  
Acute Care Setting ◽  
Face To Face ◽  
Implementation Processes ◽  
Ebp Implementation

Background: Evidence-based practice (EBP) is widely recognised as being relevant in improving nursing care. However, its implementation in nursing practice has been difficult for nurses, particularly in the developing countries. Existing evidence suggests that bureaucracy in organisational governance impacts implementation processes, however, the nature of this effect is not yet explored. Objective: The study examined experiences of nursing staff implementing EBP in a bureaucratic acute care setting in Nigeria.Methods: A qualitative exploratory design was adopted. A purposive sample of 11 ward managers and 12 staff nurses from a large acute care setting in Nigeria participated in the in-depth, face-to-face interviews. Data was analysed using the thematic analysis approach.Results: Four key themes emerged: (1) top down managerial approach; (2) nurse and nurse manager relations; (3) managerial prerogatives; (4) managerial autonomy.Conclusions and implications for practice: The Nigerian bureaucracy limits professional and managerial autonomy that nurses require in driving EBP implementation. Nurse Managers require greater leadership visibility and structural empowerment to create enabling environment for EBP implementation in nursing.

scholarly journals Nurses' Perception of Mobile Communication in an Acute Care Setting

2017 ◽  
Author(s):  
David Gardner
Keyword(s):  
Patient Safety ◽  
Response Time ◽  
Acute Care ◽  
Mobile Communication ◽  
Care Setting ◽  
Unintended Consequences ◽  
Acute Care Setting ◽  
Personal Impact ◽  
Communication Devices ◽  
The Impact

Communication is at the center of providing health with care. Good communication between nurses, patients, and among members of the health care team is paramount in delivering patient-centered care. The literature has demonstrated that mobile communication devices can improve quality and efficiency of communication among clinicians, mobilize information, improve clinical workflow, improve response time, and provide cost savings. The research has also revealed unintended consequences such as interruptions in care, increase in errors, caregiver distractions, and reductions in workflow processes. There is currently limited evidence in the literature regarding the perceptions of nurses regarding the use and satisfaction of mobile communication devices. This study examined a convenience sample of nurses (n=64) working in an acute care setting. Donabedian’s process, structure, and outcome model was used to guide this exploratory research. Registered Nurses (RNs) participated in a self-reported one-time survey on perceptions of the use of wireless mobile communication devices. The survey consisted of a 34 response Likert questionnaire which included questions about the mobile devices’ impact on communication, the personal impact the device had on nurses, the perceptions of training and implementation, the devices’ involvement in patient safety, and the overall impact of using the device. The results suggest an increase in the speed and reliability of communication with the use of a mobile communication device, improved response time to patient issues, and improved communication. However, nurses responded unfavorably regarding the impact on patient safety. Trends in data demonstrated nurses with less experience scoring more favorably than nurses with more experience. Most nurses responded unfavorably to the overall impact these devices had.

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