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Staff Experiences (staff + experience)
Selected AbstractsPractice variation in initial management and transfer thresholds for infants with respiratory distress in Australian hospitals.JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2007Who should write the guidelines? Aim: In Australian hospitals: (i) to identify current practices in the initial oxygen management of infants with respiratory distress; (ii) to identify factors important in deciding to transfer an infant; and (iii) to identify thresholds for transfer. Methods: All Australian hospitals with: >200 registered deliveries, a special care unit (SCU) or neonatal intensive care unit (NICU), and at least one paediatrician were surveyed in 2004 (n = 176). The questionnaire sought information on the initial oxygen management and factors important in deciding to transfer. Three scenarios were also used to identify thresholds for pH, carbon dioxide and oxygen levels at which transfer should occur. Responses from SCU were compared with those from NICU. Results: 15/19 (79%) NICUs and 118/157 (75%) SCUs responded. Initial oxygen management varies widely among SCUs and NICUs. NICUs set significantly lower saturation (SaO2) targets in two of the three scenarios. NICUs are statistically significantly more likely to regard ,Medical Staff Experience' and ,Time to Nearest NICU' as important compared with SCUs (P < 0.05). NICUs would ,Probably' and ,Definitely Transfer' infants at significantly lower oxygen levels in all three cases (P < 0.05). SCUs are significantly less likely to transfer babies with pH of <7.25 compared with NICUs. There was no difference between the centres for CO2 level. Conclusion: The wide variation that exists between nurseries in the initial management of infants with respiratory distress and in the thresholds for transfer strongly suggests the need for the development of practice guidelines. [source] After Adoption: Sustaining the Innovation A Case Study of Disseminating the Hospital Elder Life ProgramJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2005Elizabeth H. Bradley PhD Objectives: To examine key factors that influence sustainability in the diffusion of the Hospital Elder Life Program (HELP) as an example of an evidence-based, multifaceted, innovative program to improve care for hospitalized older adults. Design: Longitudinal, qualitative study between November 2000 and November 2003 based on 102 in-depth interviews every 6 months during HELP implementation. Setting: Thirteen hospitals implementing HELP. Participants: Forty-two hospital staff members (physician, nursing, volunteer, and administrative staff) implementing HELP, conducted 102 interviews. Measurements: Staff experiences sustaining the program, including challenges and strategies that they viewed as successful in addressing these challenges. Results: Of the 13 hospitals studied, 10 were sustaining HELP at the end of the study period; three terminated the program (after 24 months, 12 months, and 6 months). Critical factors were identified as influencing whether the program was sustained: the presence of clinical leadership, the ability and willingness to adapt the original HELP protocols to local hospital circumstances and constraints, and the ability to obtain longer-term resources and funding for HELP. Conclusion: Recognizing the need for sustained clinical leadership and funding as well as the inevitable modifications required to sustain innovative programs can promote more-realistic goals and expectations for health services researchers, clinicians, and policy makers in their laudable efforts to translate research into practice. [source] Translating Research into Clinical Practice: Making Change HappenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2004Elizabeth H. Bradley PhD Objectives: To describe the process of adoption of an evidence-based, multifaceted, innovative program into the hospital setting, with particular attention to issues that promoted or impeded its implementation. This study examined common challenges faced by hospitals implementing the Hospital Elder Life Program (HELP) and strategies used to address these challenges. Design: Qualitative study design based on in-depth, open-ended telephone interviews. Setting: Nine hospitals implementing HELP throughout the United States. Participants: Thirty-two key staff members (physician, nursing, volunteer, and administrative staff) who were directly involved with the HELP implementation. Measurements: Staff experiences implementing the program, including challenges and strategies they viewed as successful in overcoming challenges of implementation. Results: Six common challenges faced hospital staff: (1) gaining internal support for the program despite differing requirements and goals of administration and clinical staff, (2) ensuring effective clinician leadership, (3) integrating with existing geriatric programs, (4) balancing program fidelity with hospital-specific circumstances, (5) documenting positive outcomes of the program despite limited resources for data collection and analysis, and (6) maintaining the momentum of implementation in the face of unrealistic time frames and limited resources. Strategies perceived to be successful in addressing each challenge are described. Conclusion: Translating research into clinical practice is challenging for staff across disciplines. Developing strategies to address common challenges identified in this study may facilitate the adoption of innovative programs within healthcare organizations. [source] Defensibility and ethics in the laboratoryQUALITY ASSURANCE JOURNAL, Issue 2 2003Jo Ann Boyd Abstract Laboratory personnel must feel that ethical standards of conduct are a priority in the laboratory. Management must support this concept not only during training but also in daily communication to employees. Further, review of staff experience and training of employees is necessary to reinforce the need for ethics. This paper discusses defensibility and ethics in the laboratory, and the goals of assuring that the reporting of laboratory data will be performed in an ethical manner and will provide legal defensibility of data and laboratory procedures. Copyright © 2003 John Wiley & Sons, Ltd. [source] The Use of Physical Interventions with People with Intellectual Disabilities and Challenging Behaviour , the Experiences of Service Users and Staff MembersJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2005Sarah Hawkins Background, The views of both service users with intellectual disability and their support staff on the use of physical interventions are largely unknown. The research that does exist describes a largely negative pattern of responses. The present study aimed to explore the personal impact of receiving and implementing physical interventions, and also how service users and staff felt the use of such procedures impacted on each other. Method, Eight service user/staff pairs were interviewed about their experiences of physical intervention within 1 week of their mutual involvement in a behavioural incident requiring restraint use. A qualitative methodology was employed to obtain views on a non-pain compliance approach to physical intervention. Results, Service user and staff experiences were intrinsically linked, highlighting the interactional nature of physical interventions. It was apparent that experiences of physical intervention were dependent on far more than the application of techniques alone. Conclusions, Participants' accounts were primarily negative. Service user and staff experiences were clearly affected by their appraisals of each other's behaviour throughout the physical intervention process. [source] Tracheostomy management in Acute Care Facilities , a matter of teamworkJOURNAL OF CLINICAL NURSING, Issue 9-10 2010Vicki Parker Aim., Implement and evaluate an inter-disciplinary team approach to tracheostomy management in non-critical care. Background., Trends towards early tracheostomy in intensive care units (ICU) have led to increased numbers of tracheostomy patients. Together with the push for earlier discharge from ICU, this poses challenges across disciplines and wards. Even though tracheostomy is performed across a range of patient groups, tracheostomy care is seen as the domain of specialist clinicians in critical care. It is crucial to ensure quality care regardless of the patient's destination after ICU. Design., A mixed method evaluation incorporating quantitative and qualitative approaches. Method., Data collection included pre-implementation and postimplementation clinical audits and staff surveys and a postimplementation tracheostomy team focus group. Descriptive and inferential analysis was used to identify changes in clinical indicators and staff experiences. Focus group data were analysed using iterative processes of thematic analysis. Results., Findings revealed significant reductions in mean hospital length of stay (LOS) for survivors from 50,27 days (p < 0·0001) and an increase in the number of tracheostomy patients transferred to non-critical care wards in the postgroup (p = 0·006). The number of wards accepting patients from ICU increased from 3,7 and there was increased staff knowledge, confidence and awareness of the team's role. Conclusion., The team approach has led to work practice and patient outcome improvements. Organisational acceptance of the team has led to more wards indicating willingness to accept tracheostomy patients. Improved communication has resulted in more timely referral and better patient outcomes. Relevance to clinical practice., This study highlights the importance of inter-disciplinary teamwork in achieving effective patient outcomes and efficiencies. It offers a model of inter-disciplinary practice, supported by communication and data management that can be replicated across other patient groups. [source] An exploratory, interview study of oncology patients' and health-care staff experiences of discussing resuscitationPSYCHO-ONCOLOGY, Issue 11 2007Karen Cox Abstract There is little research about how patients and their families would like discussions surrounding resuscitation to take place. The purpose of this exploratory study was to investigate the experience of a discussion of resuscitation from the perspective of the participants. In-depth interviews were undertaken with 21 patients, of whom nine were interviewed together with a relative and 14 staff in an oncology setting. Data were analysed using a constant comparative method and coded using NVIVO qualitative data analysis software. Patients appeared to be accepting resuscitation discussions as necessary and important. A minority felt that the timing of the discussion could have been better, particularly if they were newly diagnosed or had recently commenced treatment. Relatives generally found the discussions more difficult and felt that discussions should take place much closer to death. Patients identified that they needed time and privacy during the discussion. Staff identified a need to present a sensitive and individualised discussion which took into account the key elements of timing, place, space, manner and pace. Patients acknowledged that the resuscitation discussion enabled them to begin to address issues relating to dying and end of life. For staff on-going communication skills training and support in this area were seen as important but often overlooked parts of the process. Copyright © 2007 John Wiley & Sons, Ltd. [source] | ||||||||||