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Healthcare Environment (healthcare + environment)
Selected AbstractsLegal Considerations of Workplace Violence in Healthcare EnvironmentsNURSING FORUM, Issue 1 2001Yvonne McKoy RN.PhD First page of article [source] Systematic review of the perceptions and experiences of accessing health services by adult victims of domestic violenceHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2008Louise Robinson RGN RHV BSc (Hons) MSc Abstract This systematic review synthesises evidence on the perceptions and experiences of adult victims of domestic violence when accessing healthcare services. The review was concerned with disclosure of domestic violence by adult victims when accessing health services, the responses of healthcare professionals to these victims, victims' perceived barriers to support, and the appropriateness of support and referrals. These aims required the review to focus on studies using in-depth qualitative methods to explore victims' perceptions and experiences. A comprehensive systematic search of 12 databases was carried out in June/July 2005. Application of the review protocol and inclusion criteria resulted in 10 studies (conducted in the UK, USA and Australia) being considered eligible for the review. Data were extracted from these studies and a quality assessment completed. Thematic analysis was carried out to enable the identification of recurrent themes within the included studies. Findings indicate that victims of domestic violence experience difficulties when accessing healthcare services. Victims perceive that these difficulties can be attributed to inappropriate responses by healthcare professionals, discomfort with the healthcare environment, perceived barriers to disclosing domestic violence, and a lack of confidence in the outcomes of disclosure to a health professional. The methodological quality of included studies was variable, but no papers were rejected based on quality issues. These results can contribute to and inform a comprehensive assessment of the experiences of adult victims of domestic violence when accessing healthcare services. The health service is in a unique position to contribute towards the assessment and identification of domestic violence and to provide access to appropriate support. The messages of this study are important for policy-makers and practitioners. [source] Systematic review on embracing cultural diversity for developing and sustaining a healthy work environment in healthcareINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 1 2007Alan Pearson RN, FRCN, FRCNA Abstract Objectives, The objective of this review was to evaluate evidence on the structures and processes that support development of effective culturally competent practices and a healthy work environment. Culturally competent practices are a congruent set of workforce behaviours, management practices and institutional policies within a practice setting resulting in an organisational environment that is inclusive of cultural and other forms of diversity. Inclusion criteria, This review included quantitative and qualitative evidence, with a particular emphasis on identifying systematic reviews and randomised controlled trials. For quantitative evidence, other controlled, and descriptive designs were also included. For qualitative evidence, all methodologies were considered. Participants were staff, patients, and systems or policies that were involved or affected by concepts of cultural competence in the nursing workforce in a healthcare environment. Types of interventions included any strategy that had a cultural competence component, which influenced the work environment, and/or patient and nursing staff in the environment. The types of outcomes of interest to this review included nursing staff outcomes, patient outcomes, organisational outcomes and systems level outcomes. Search strategy, The search sought both published and unpublished literature written in the English language. A comprehensive three-step search strategy was used, first to identify appropriate key words, second to combine all optimal key words into a comprehensive search strategy for each database and finally to review the reference lists of all included reviews and research reports. The databases searched were CINAHL, Medline, Current Contents, the Database of Abstracts of Reviews of Effectiveness, The Cochrane Library, PsycINFO, Embase, Sociological Abstracts, Econ lit, ABI/Inform, ERIC and PubMed. The search for unpublished literature used Dissertation Abstracts International. Methodological quality, Methodological quality was independently established by two reviewers, using standardised techniques from the Joanna Briggs Institute (JBI) System for the Unified Management, Assessment and Review of Information (SUMARI) package. Discussion with a third reviewer was initiated where a low level of agreement was identified for a particular paper. Following inclusion, data extraction was conducted using standardised data extraction tools from the JBI SUMARI suite for quantitative and qualitative research. Data synthesis was performed using the JBI Qualitative Assessment and Review Instrument and JBI Narrative, Opinion and Text Assessment and Review Instrument software to aggregate findings by identifying commonalities across texts. Quantitative data were presented in narrative summary, as statistical pooling was not appropriate with the included studies. Results, Of the 659 identified papers, 45 were selected for full paper retrieval, and 19 were considered to meet the inclusion criteria for this review. The results identified a number of processes that would contribute to the development of a culturally competent workforce. Appropriate and competent linguistic services, and intercultural staff training and education, were identified as key findings in this review. Conclusions, The review recommends that health provider agencies establish links with organisations that can address needs of culturally diverse groups of patients, include cultural competence in decision support systems and staff education as well as embed them in patient brochures and educational materials. The review also concluded that staff in-service programs consider the skills needed to foster a culturally competent workforce, and recruitment strategies that also explicitly address this need. [source] Factors associated with constructive staff,family relationships in the care of older adults in the institutional settingINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 4 2006Emily Haesler BN PGradDipAdvNsg Abstract Background, Modern healthcare philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's well-being. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family involvement in the healthcare of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the healthcare environment to benefit from the involvement of their family members, healthcare professionals need an understanding of the issues surrounding family presence in the healthcare environment and the strategies to best support it. Objectives, The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff,family relationships in the care of older adults in the healthcare setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff,family relationships. Search strategy, A literature search was performed using the following databases for the years 1990,2005: Ageline, APAIS Health, Australian Family and Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage was conducted through review of reference lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language. Selection criteria, The review was limited to studies involving residents and patients within acute, subacute, rehabilitation and residential settings, aged over 65 years, their family and healthcare staff. Papers addressing family members and healthcare staff perceptions of their relationships with each other were considered for this review. Studies in this review also included those relating to interventions to promote constructive staff,family relationships including organisational strategies, staff,family meetings, case conferencing, environmental approaches, etc. The review considered both quantitative and qualitative research and opinion papers for inclusion. Data collection and analysis, All retrieved papers were critically appraised for eligibility for inclusion and methodological quality independently by two reviewers, and the same reviewers collected details of eligible research. Appraisal forms and data extraction forms designed by the Joanna Briggs Institute as part of the QARI and NOTARI systematic review software packages were used for this review. Findings, Family members' perceptions of their relationships with staff showed that a strong focus was placed on opportunities for the family to be involved in the patient's care. Staff members also expressed a theoretical support for the collaborative process, however, this belief often did not translate to the staff members' clinical practice. In the studies included in the review staff were frequently found to rely on traditional medical models of care in their clinical practice and maintaining control over the environment, rather than fully collaborating with families. Four factors were found to be essential to interventions designed to support a collaborative partnership between family members and healthcare staff: communication, information, education and administrative support. Based on the evidence analysed in this systematic review, staff and family education on relationship development, power and control issues, communication skills and negotiating techniques is essential to promoting constructive staff,family relationships. Managerial support, such as addressing workloads and staffing issues; introducing care models focused on collaboration with families; and providing practical support for staff education, is essential to gaining sustained benefits from interventions designed to promote constructive family,staff relationships. [source] Director of nursing and midwifery leadership: informed through the lens of critical social scienceJOURNAL OF NURSING MANAGEMENT, Issue 4 2010ANNETTE SOLMAN RN, Dip HSN, Masters NR solman a. (2010) Journal of Nursing Management18, 472,476 Director of nursing and midwifery leadership: informed through the lens of critical social science Aims, Highlight the use of critical social science theories, practice development principles and a situational leadership framework within transformational leadership to inform Directors of Nursing and Midwifery (DoNM) practices as leaders. Background, Healthcare is constantly changing, unpredictable, strives for quality service and cost containment, which can result in stress and crisis for healthcare workers. DoNM leadership is critical to supporting and leading staff through these complex times within healthcare. Key issues, Understanding theories, frameworks and their application to real-world practice can assist in supporting individuals and teams to navigate through the changing healthcare environment. Conclusion, Blending critical social science theories with practice development principles and the situational leadership framework can assist the DoNM to enact transformational leadership to support the development of individuals and teams to meet the complex healthcare needs of patients within the clinical setting. Implications for nurse management, This article contributes through the practical application of critical social science theories, practice development principles and situational leadership framework within transformational leadership as an approach for enacting DoNM leadership. To further understand and develop in the role of the contemporary DoNM in leadership, these directors are encouraged to publish their work. [source] Returning Nurses to the Workforce: Developing a Fast Track Back ProgramNURSING FORUM, Issue 3 2006Helen K. Burns PhD TOPIC., Fast Track Back: Re-entry into Nursing Practice program. PURPOSE AND SOURCES OF INFORMATION.,Describes the development, implementation, and evaluation of a state-of-the-art re-entry program facilitating the return of licensed nonpracticing RNs to the workforce through a quality education program that retools them for the workforce in the areas of pharmacology, skill development using the latest technology, practice standards, and nursing issues. The program consists of didactic content taught via classroom, Internet, skills laboratory, and high fidelity human simulated technology and a clinical component. CONCLUSIONS.,The program is a mechanism that enables re-entry nurses to improve skills and competencies necessary to practice in today's healthcare environment. [source] Flexibility: A Concept AnalysisNURSING FORUM, Issue 1 2000Michele August-Brady RN Flexibility is a quality that is deemed essential for nursing as the healthcare environment escalates into greater complexity. The word "flexibility" appears in nursing literature addressing the need to prepare for the next millenium, yet the concept of flexibility is rarely defined. Other disciplines, such as engineering, have struggled for years and continue to struggle to achieve conceptual clarity with regard to flexibility. A concept analysis using Rodgers' evolutionary method was undertaken to understand the meaning of flexibility. [source] Are therapeutic ultrasound units a potential vector for nosocomial infection?PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2006Siobhan Schabrun Abstract Background and Purpose.,Nosocomial infections present a widespread problem in today's healthcare environment, with a significant number of patients acquiring an infection annually. With the contemporary transition of immunocompromised and high-risk patients to community-based care, therapeutic ultrasound has the potential to be a vector of infection in the physiotherapy setting. The purpose of the present study was to determine the degree of contamination on therapeutic ultrasound transducer heads and ultrasound gel after routine clinical use, and to evaluate the efficacy of recommended infection control procedures.,Method.,The study consisted of two phases. Using a prospective cross-sectional design, microbiological cultures were obtained from 44 transducer heads and 43 gels. Subjects were drawn from a variety of physiotherapy practice settings. All samples containing more than five colony forming units per cm2 were considered contaminated. Following these measurements, a repeated-measures design was used to re-evaluate the 44 transducer heads for the amount and type of bacteria present after cleaning with a 70% alcohol wipe.,Results.,Twenty-seven per cent of transducer heads and 28% of gels were contaminated. Transducer heads showed fairly low levels of contamination across the sample, with the majority of organisms isolated found in normal skin and environmental flora. Gels were heavily contaminated with opportunistic and potentially pathogenic organisms, including Stenotrophomonas maltophilia, Staphylococcus aureus, Acinetobacter baumannii and Rhodotorula mucilaginosa. No multi-resistant organisms were identified. Cleaning with 70% alcohol significantly reduced the level of contamination on transducer heads (p < 0.01).,Conclusions.,Therapeutic ultrasound equipment is a potential vector for nosocomial infection in physiotherapy patients. The risk of infection from transducer heads can be effectively removed by cleaning with 70% alcohol between patients. Further research into possible strategies to reduce the risk of infection from ultrasound gels is needed. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||