Search results

The purpose of this paper is to determine what patient and family stories can tell us about patient safety culture within health care organizations and how patients experience patient safety culture.

A total of 11 patient and family stories of adverse event experiences were examined in September 2013 using publicly available videos on the Canadian Patient Safety Insitute web site. Videos were transcribed verbatim and collated as one complete data set. Thematic analysis was used to perform qualitative inquiry. All qualitative analysis was done using NVivo 10 software.

A total of three themes were identified: first, Being Passed Around; second, Not Having the Conversation; and third, the Person Behind the Patient. Results from this research also suggest that while health care organizations and providers might expect patients to play a larger role in managing their health, there may be underlying reasons as to why patients are not doing so.

The findings indicate that patient experiences and narratives are useful sources of information to better understand organizational safety culture and patient experiences of safety while hospitalized. Greater inclusion and analysis of patient safety narratives is important in understanding the needs of patients and how patient safety culture interventions can be improved to ensure translation of patient safety strategies at the frontlines of care.

Greater acknowledgement of the patient and family experience provides organizations with an integral perspective to assist in defining and addressing deficiencies within their patient safety culture and to identify opportunities for improvement.

Patients with chronic obstructive pulmonary disease (COPD) suffer many physical disabilities which cause many problems in their life. These patients really need to have continuity of care based on cooperation between patient, the family and their care givers in order to achieve an integration of care. The purpose of this paper is to assess the impact of continuous care on quality of life of patients with COPD.

A before–after quasi-experimental study was carried out with 72 patients with COPD at Beheshti educational hospital of Hamadan University of Medical Sciences. The patients who met inclusion criteria were randomly allocated into an intervention group (n=36) and a control group (n=36). The patients completed the St George’s Respiratory Questionnaire before and after their care. The intervention comprised continuous care with orientation and sensitization sessions (2 weeks), control and evaluation sessions (45 days) for intervention group and with routine care in the control group. Data were analyzed with SPSS, descriptive and inferential statistics were conducted to measure differences between intervention and control group.

Continuity of care improved significantly the quality of life of COPD patients in general, and in the symptoms, activity and impact domains (P=0.001). In contrast, routine care did not improve quality of life for patients in general, and in the symptoms, activity and impact domains (P=0.05).

Continuity of care has a positive impact on quality of life for COPD patients. Health care system should utilize continuity of care models as an overall plan for patients with COPD. Moreover, managers of health care system could reduce burden of chronic diseases by employing continuity of care models in planning patient care.

Treatment of coeliac disease (CD) is essentially dietary and requires permanent changes in dietary habits. Gluten‐free diet compliance affects every aspect of an individual's quality of life. This paper aims to analyse the difficulties associated with the food practices tried and reported by CD patients and their health and quality of life.

A questionnaire with open, closed and multiple choice questions adapted from an already validated instrument was administered to a sample of 105 CD patients. The inclusion criteria were patients diagnosed with CD living in Distrito Federal (DF) who agreed to participate in the study.

The greatest concerns of CD patients were eating out (44.23 per cent), having to read food labels (50.00 per cent), believing that foods are not safe (52.88 per cent) and not having dietary alternatives (56.44 per cent). Some (39.42 per cent) patients have no difficulty following the diet, 42.3 per cent have some difficulty and 18.27 per cent find it very difficult to follow the diet.

This study discloses some of the social difficulties faced by CD patients, such as eating with relatives and friends, and discusses the impact of these challenges on their quality of life. The data show that information can help CD patients to maintain their quality of life.

The purpose of this paper is to understand and develop ways to enhance patients’ experiences of preoperative education received prior to surgery for colorectal cancer.

Based in the UK, three-action research cycles were undertaken to evaluate preoperative education, identify changes seen by patients and staff as likely to improve the service and to re-evaluate such changes following implementation. Data in each cycle were collected from: observations of clinic interactions; patient questionnaires; individual semi-structured interviews with multidisciplinary colorectal unit staff; longitudinal semi-structured interviews with patients and carers pre-surgery, two weeks post-surgery and 12 weeks post-surgery; patient and carer focus groups post-surgery; and existing educational material.

In total, 138 participants shared their experiences of either giving or receiving preoperative education. Findings were themed into why patients want preoperative education, and patients’ views of the educational processes.

Patients emphasised the need for educational provision to be fully understandable, comprehensive and client-centred using a range of communication processes. Patients emphasised the need for educational provision to be more fully understandable, comprehensive and client-centred and that important messages should be reinforced using a range of media. At a time of many uncertainties for patients’ lives, such education needed to encompass the experiences patients could expect, delivered by confident healthcare professionals.

Contextualising understanding and facilitating their own actions, enabled patients to regain control in circumstances particularly disruptive of bodily and other life routines. Establishing a sense of control is confirmed as important for patient's wellbeing in preparing for surgery and postoperative rehabilitation.

Evaluates care plans documented in two different ways, using controlled and randomised studies of consecutive acutely admitted medical patients. Within 24 hours after admission, a care plan was made for the hospital stay, specifying active problems, a plan of action and a time‐schedule. In study 1, patients had care plans written directly into their medical records during the intervention period, while the normal admittance procedure was followed in the control period. In study 2, all patients had a care plan made on a planning form and in the medical record. Patients were randomised either to have the form stay in the medical record or to have it removed. Study 1 results showed that care plans were associated with earlier recognition of patients’ active problems, whereas the tendency to initiate solutions to active problems earlier was insignificant. Length of stay (LOS) and risk of readmission remained unchanged. In study 2, planning forms were associated with a 1.5‐day lower LOS and higher accuracy of planned LOS. Risk of readmission and accomplishment of plans of action were unaltered.

This study aims to examine the relationship between neutrophil to lymphocyte ratio (NLR), handgrip strength (HGS) and nutritional status in non-critically ill patients and outpatients.

A cross-sectional study was conducted on 80 geriatric patients. Nutritional status was evaluated using the Mini Nutritional Assessment Short Form, Geriatric Nutritional Risk Index, some anthropometric and biochemical parameters. NLR was calculated from the complete blood count results. Data were analyzed using SPSS 24.0.

While 38.3% of patients were malnourished or at risk of malnutrition, 61.7% had normal nutritional status. Mini Nutritional Assessment Short Form was not correlated with NLR, whereas it showed a weak positive correlation with HGS. According to the logistic regression analysis, age, HGS, hemoglobin and platelet to lymphocyte ratio were significant independent factors for predicting malnutrition or risk of malnutrition. The receiver operator characteristic curve analysis showed that the optimum HGS cut-off point for patients with malnourished or at risk of malnutrition was 13.2. In conclusion, HGS was associated with the nutritional status. NLR was not associated with nutritional status but associated with nutritional risk.

It is well known that malnutrition is a serious health problem among older adults, and it is important to assess the nutritional status of older adults because of the adverse health effects. In addition, to the best of the authors’ knowledge, this is the first study to determine the relationship between NLR, HGS and nutritional status in non-critically ill patients and outpatients.

This paper aims to provide an insight into the design, development and delivery proposals for a first of its kind “Liaison Mental Health Training Programme”. In the UK, there has been a significant investment in Liaison Mental Health Services and an expansion of the workforce (NHS England, 2016). However, the complexity and varied presentations of patients who attend to acute physical health services now requires a dedicated strategy to address any skills deficit in the mental health liaison workforce and to support core competency development (DOH, 2016).

This paper provides an overview of preparations to develop a regional educational pilot programme using a three-phased model: Phase 1 – Review of policy and best practice guidelines; Phase 2 – Stakeholder Data Collection; and Phase 3 – Synthesis and Development.

An insight into the developmental processes undertaken to shape a core competency liaison mental health training programme is presented. Additionally, the authors provide insight into educational theory and an overview of the LMH Core Competency Curricula.

This paper provides the reader with an insight into our findings and a focussed core competency training model for those working within LMH services. This programme development was reviewed throughout by both those using LMH services and the LMH practitioners working within them, ensuring the curriculum proposed was endorsed by key stakeholders. The three-phased model has transferable benefits to other training development initiatives.

To the best of the authors’ knowledge, this training is the first of its kind in the UK and addresses the education of essential core competencies of a regional liaison mental health workforce. The collaboration of clinical and academic expertise and model of co-production makes this endeavour unique.

To evaluate the impact of rationing guidelines on the practice of reduction mammaplasty, with particular reference to patient selection.

A retrospective audit was performed. Patients who were accepted for surgery in the first nine months following the date of publication of new and explicit inclusion criteria were compared with patients who were accepted for surgery in the 15 months preceding publication.

Of 131 consecutive patients, 98 were accepted before publication of the inclusion criteria, with 33 after. A total of the 97 of 98 and 33 of 33 were symptomatic. Conformity to criteria for body mass index (BMI) increased from 65 of 98 (66 per cent) to 25 of 33 (76 per cent, p=0.143) Attendance at pre‐operative breast seminar increased from 72 of 98 (73 per cent) to 29 of 33 (88 per cent, p=0.099). Incidence of smoking increased from 18 of 98 (18 per cent) to 7 of 33 (21 per cent, p=0.799). Patients under the age of 30 accounted for this increase. The number of cases who failed on more than one criterion fell from 17 of 98 (7 per cent) to 2 of 33 (3 per cent, p=0.155).

Demonstrates a non‐significant reduction in the number of obese patients being accepted for surgery, and a non‐significant increase in uptake of pre‐operative nurse led seminars in the practice. Since publication of the inclusion criteria, all but one of the patients accepted for surgery with exclusion criteria failed on the basis one criterion only. Not successful in enforcing abstinence from smoking as a condition for surgery, particularly among younger patients. To help do this objective ways to assess smoking status need to be looked at. A re‐audit is required to complete the loop.

This is the first paper to present audit results for the new inclusion criteria for reduction mammaplasty.

The purpose of this paper is to explore perceived barriers to the recruitment and retention of Black and Minority Ethnic community individuals partaking in healthcare education role playing activities using simulated patient scenarios.

A qualitative, exploratory study was conducted with a self‐selecting, convenience, sample of 25 participants from Black and Minority communities using one‐to‐one and group interviews to elicit data. Ethical approval was successfully received from the University.

Five broad emergent themes were identified: language, knowledge, power, inequalities and inclusion.

The participants' sharing of their own experiences developed a feeling of personal achievement through an understanding in others of their own community and values.

The purpose of this paper is to argue that monitoring of symptoms through self‐assessed data is not only a vital part of record taking in mental health care, but can also aid patients in their recovery, giving them more of a say in their healthcare, and providing a record of progress for both patients and clinicians.

A literature search was undertaken to identify ways in which self‐assessed data is used in mental health care and to examine how successful this approach may be in aiding recovery and whether patients are able and enthusiastic to participate in this approach. Ideas for effective approaches to utilising self‐assessed data into mental health care are suggested.

There were clear indications from the literature that the use of self‐assessed data improves health outcomes and that patients enjoy the process. This approach promotes greater inclusion of individuals in the management of their health care.

Self‐assessed data can be presented to doctors which may inform their decisions about their patients and be used as a reference for patients to see their progress towards recovery. It may also aid recognition of symptoms by patients.

The paper proposes that self‐assessed data should be used routinely in mental health care to complement traditional note taking by clinicians. It sets out a unique method for recording symptoms using a simple, easy to use, symptom scale. It is also proposes to measure medication dose and type, so that progress or otherwise can be compared with medication over time.