To err is human: medication patient safety in aged care, a case study
- Authors: Gilbert, Julia , Kim, Jeong-Ah
- Date: 2018
- Type: Text , Journal article
- Relation: Quality in Ageing and Older Adults Vol. 19, no. 2 (2018), p. 126-134
- Full Text:
- Reviewed:
- Description: Purpose: The purpose of this paper is to explore an identified medication error using a root cause analysis and a clinical case study. Design/methodology/approach: In this paper the authors explore a medication error through the completion of a root cause analysis and case study in an aged care facility. Findings: Research indicates that medication errors are highly prevalent in aged care and 40 per cent of nursing home patients are regularly receiving at least one potentially inappropriate medicine (Hamilton, 2009; Raban et al., 2014; Shehab et al., 2016). Insufficient patient information, delays in continuing medications, poor communication, the absence of an up-to-date medication chart and missed or significantly delayed doses are all linked to medication errors (Dwyer et al., 2014). Strategies to improve medication management across hospitalisation to medication administration include utilisation of a computerised medication prescription and management system, pharmacist review, direct communication of discharge medication documentation to community pharmacists and staff education and support (Dolanski et al., 2013). Originality/value: Discussion of the factors impacting on medication errors within aged care facilities may explain why they are prevalent and serve as a basis for strategies to improve medication management and facilitate further research on this topic.
Nonstandard advance health care directives in emergency departments : Ethical and legal dilemma or reality : A narrative review
- Authors: Gilbert, Julia , Boag, Jane
- Date: 2018
- Type: Text , Journal article
- Relation: Advanced Emergency Nursing Journal Vol. 40, no. 4 (2018), p. 324-327
- Full Text: false
- Reviewed:
- Description: People have tattooed themselves for thousands of years, and it remains popular with various groups across mainstream society. Although many people choose tattoos that express their life philosophy, epic events in their life, or their personal mantra, the use of tattooing in medicine such as a "do not resuscitate" tattoo is increasingly becoming more common (Drew, 2017; Islam et al., 2016). As these tattoos do not meet the legal requirements for an advance health directive, they are at best a guide to the person's wishes and at worst a useless, painful exercise. New technology such as "talking tattoos" or implantable microchips could conceivably be used to record either an audible advance health directive or directions for emergency responders to access an individual's advance health directive. This article discusses the ethical and legal implications of nonstandard advance health directive tattoos in emergency treatment situations.
Factors influencing hand hygiene practice of nursing students : a descriptive, mixed-methods study
- Authors: Zimmerman, Peta-Anne , Sladdin, Ishtar , Shaban, Ramon , Gilbert, Julia , Brown, Lynne
- Date: 2020
- Type: Text , Journal article
- Relation: Nurse Education in Practice Vol. 44, no. (2020), p.
- Full Text: false
- Reviewed:
- Description: Developing nursing students' knowledge and practice of infection prevention and control (IPC) is fundamental to safe healthcare. A two-phase descriptive, mixed-method study conducted within a Bachelor of Nursing program at an Australian university aimed to explore: (i) theoretical knowledge of IPC, highlighting hand hygiene, of nursing students and; (ii) nursing students' and clinical facilitators' perceptions of factors influencing these practices during clinical placement. Phase One utilised an anonymous validated questionnaire assessing students' knowledge; identifying variables influencing students' IPC practices, subjected to descriptive and inferential analysis. Phase Two were semi-structured interviews exploring clinical facilitators' experiences/perceptions of students during clinical placement, analysed thematically. Students' demonstrated satisfactory knowledge of IPC in their second and third year, but clinical facilitators perceived that. students lacked awareness of the importance of these practices. Five themes arose from the interviews: (i) understanding workplace culture; (ii) students' modelling local behaviour; (iii) enhancing and consolidating knowledge for practice; (iv) adjusting to practice reality and; (v) accessing additional hand hygiene resources. Factors specific to workplace setting and culture were perceived to influence nursing students' socialisation. Future practice/education strategies could address these factors by ensuring students receive adequate supervision during clinical placement, and having strong advocates/role models present in the workplace. © 2020 Elsevier Ltd
Public perception of medical errors : experiences and risks shared in Australia
- Authors: Kim, Jeong-ah , Terry, Daniel , Jang, Sunny , Nguyen, Hoang , Gilbert, Julia , Cruickshank, Mary
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 1 (2020), p. 35-41
- Full Text:
- Reviewed:
- Description: Background: Research into patient safety has largely focused on healthcare organisations bureaucratic routines, with little research available regarding the impact of patient perceptions on clinical practice. Acknowledging and openly discussing patient perceptions of medical errors may result in improved quality of healthcare. The research study aimed to gain a better understanding of the public's perception of medical errors to drive a structured approach to improve healthcare outcomes. Methods: In this study, we examined the public experiences of medical errors using an anonymous on-line survey to collect empirical data from April to December 2018. A total of 407 responses were obtained with 303 participants meeting the criteria for inclusion in the study. Results: The majority (74.9%) of these participants identified that they had experienced a medical error during receiving healthcare in Australia and 73% of these confirmed that they were harmed as a result of these errors. Conclusion: Findings from this study indicate that many participants have experienced medical errors when accessing healthcare in Australia. These findings provide information and a deeper understanding of patient experiences and perceptions of healthcare service delivery which can be used by healthcare organisations to improve healthcare services and promote patient participation in their care. Copyright©2020 by authors, all rights reserved. Authors agree that this article remains permanently open access under the terms of the Creative Commons Attribution License 4.0 International License
Chronic obesity
- Authors: Hohol, Amali , Gilbert, Julia , Johnston, Melissa
- Date: 2019
- Type: Text , Book chapter
- Relation: Chronic Care Nursing: A Framework for Practice p. 243-258
- Full Text: false
- Reviewed:
A labour of love : reward and satisfaction for nurses : findings from a grounded theory study in dementia care
- Authors: Gilbert, Julia , Ward, Louise , Walter, Ruby
- Date: 2021
- Type: Text , Journal article
- Relation: Dementia Vol. 20, no. 5 (2021), p. 1697-1710
- Full Text: false
- Reviewed:
- Description: Aim: To understand nurses’ perceptions of quality nursing care in the dementia-specific care unit. As the world’s population ages, the incidence of dementia is projected to rise in tandem. The requirement for skilled, dementia-trained registered nurses who can provide quality nursing care will need to increase accordingly to meet the needs of these individuals. Extensive research has been completed on dementia nursing care in a variety of settings; however, little research has been undertaken into nurses’ perceptions of quality nursing care in the dementia-specific care unit. Understanding how registered nurses perceive quality nursing care in the dementia-specific care unit is important and provides valuable information about nursing practice in this environment for nurses and decision-makers. Gaining a better understanding of quality nursing care in this care unit may result in better nurse education and an improved patient experience. It may also assist nursing organisations, residential aged-care facilities, government bodies and nongovernment agencies that support, manage, and oversee dementia-specific care units. Method: A grounded theory study was conducted to understand nurses’ perceptions of quality nursing care in dementia-specific care units. The study involved interviewing nine registered nurses working in two dementia-specific care units on the Gold Coast, Queensland. Data were collected during semi-structured interviews and analysed using both constant comparison and thematic analysis. Findings: Three themes emerged from this study—Caring at the Coalface, Labour of love and the Business of Dementia Healthcare. The largest theme, Labour of love, represents the personal reward and feeling of satisfaction six nurses said they experienced when interacting with individuals living in the dementia-specific care unit. They identified and repeatedly discussed the joy and fulfilment they experienced when caring for them, and considered this to be an essential element of quality nursing care. It was evident from the data that the nurses cared very deeply about these individuals, and despite increased risks to personal safety at work, they did not want to work anywhere else. This article reports on the largest and key theme identified in the study Labour of Love. © The Author(s) 2020.
'To die, to sleep' - assisted dying legislation in Victoria : A case study
- Authors: Gilbert, Julia , Boag, Jane
- Date: 2019
- Type: Text , Journal article
- Relation: Nursing Ethics Vol. 26, no. 7-8 (2019), p. 1976-1982
- Full Text: false
- Reviewed:
- Description: Background: Assisted dying remains an emotive topic globally with a number of countries initiating legislation to allow individuals access to assisted dying measures. Victoria will become the first Australian state in over 13 years to pass Assisted Dying Legislation, set to come into effect in 2019. Objectives: This article sought to evaluate the impact of Victorian Assisted Dying Legislation via narrative view and case study presentation. Research design: Narrative review and case study. Participants and research context: case study. Ethical considerations: This legislation will provide eligible Victorian residents with the option to request access to assisted dying measures as a viable alternative to a potentially painful, protracted death. Findings: This legislation, while conservative and inclusive of many safeguards at present, will form the basis for further discussion and debate on assisted dying across Australia in time to come. Discussion: The passing of this legislation by the Victorian parliament was prolonged, emotive and divided not only the parliament but Australian society. Conclusion: Many advocates for this legislation proclaimed it was well overdue and will finally meet the needs of contemporary society. Protagonists claim that medical treatment should not provide a means of ending life, despite palliative care reportedly often failing to relieve the pain and suffering of individuals living with a terminal illness.
Quality nursing care in dementia specific care units : a scoping review
- Authors: Gilbert, Julia , Ward, Louise , Gwinner, Karleen
- Date: 2019
- Type: Text , Journal article
- Relation: Dementia Vol. 18, no. 6 (2019), p. 2140-2157
- Full Text: false
- Reviewed:
- Description: Background: The concept of quality nursing care in a dementia specific unit is perceived as being subject to the interpretation of individuals, nurses and healthcare organisations. As the number of dementia diagnoses increases, understanding what constitutes quality nursing care within dementia specific care units is vital to inform policy makers and healthcare organisations globally. Efforts to identify quality nursing care and improve dementia care within dementia specific care units, may significantly reduce the financial and emotional burden of care-giving and improve the quality of life for individuals living with dementia. This scoping review aimed to examine current literature to gain an understanding of what constitutes quality nursing care in a dementia specific care unit. Design and methods: Five electronic databases (CINAHL, MEDLINE, ProQuest, Social Sciences Citation Index and Ovid) were used to search for articles published in English between 2011 and 2016 focusing on a definition of quality nursing care within dementia specific care units. Findings: Twenty journal articles were identified. From these articles, two content themes were identified: Challenges in the provision of quality nursing care in dementia specific care units, and Standardised approach to quality nursing care in a dementia specific care unit. The articles contained the following research designs, controlled pre-test and post-test design (n = 1), focus group interviews (n = 1), cross sectional survey (n = 6), semi structured interviews (n = 3), narrative review (n = 1), survey (n = 2), literature review (n = 3), systematic review (n = 1), and prospective longitudinal cohort study (n = 2). Conclusions: The concept of quality nursing care in a dementia specific unit remains subject to the interpretation of individuals, nurses and healthcare organisations, with current literature unable to provide a clear definition. Further research into what constitutes quality nursing care in dementia specific care units is recommended. © The Author(s) 2017.
Diabetes mellitus
- Authors: Gilbert, Julia , Chapman, Ysanne , Hooge, Sharon
- Date: 2019
- Type: Text , Book chapter
- Relation: Chronic Care Nursing: A Framework for Practice p. 184-201
- Full Text: false
- Reviewed:
Dementia care
- Authors: Gilbert, Julia , Croxon, Lyn , Ashcroft, Bronwen
- Date: 2019
- Type: Text , Book chapter
- Relation: Chronic Care Nursing: A Framework for Practice p. 259-274
- Full Text: false
- Reviewed:
“Thank You for Listening” : an exploratory study regarding the lived experience and perception of medical errors among those who receive care
- Authors: Terry, Daniel , Kim, Jeong-Ah , Gilbert, Julia , Jang, Sunny , Nguyen, Hoang
- Date: 2022
- Type: Text , Journal article
- Relation: International Journal of Health Services Vol. 52, no. 2 (2022), p. 292-302
- Full Text: false
- Reviewed:
- Description: The issue of medical errors, or adverse events caused within a health care context or by a health care provider, is largely under-researched. While the experience and perspective of health care professionals regarding medical errors have been explored, little attention is paid to the health care consumers regarding their perceptions and experiences. Therefore, there is a need to better understand the public’s views on medical errors to enhance patient safety and quality care. The current study sought to examine Australian public perceptions and experiences, especially concerning what errors had occurred, the perceived sources of the errors, and if the errors had been reported. This paper reports the qualitative findings of an online survey for Australian residents who have accessed or received medical services at any time in Australia. Responses from 304 surveys were analyzed and discussed, including demographic information and key themes about medical errors, which were categorized into engagement and patients’ voices being heard, the quality of care being provided, and the system’s accountability. Based on the findings, the study highlights the importance of effective health professional–patient communication, enhanced capacity to deliver high quality care, and improved mechanism for error reporting and resolution where patients feel safe and confident about positive changes being made. © The Author(s) 2019.
Nurse leadership in promoting and supporting civility in health care settings : a scoping review
- Authors: Ota, Marianne , Lam, Louisa , Gilbert, Julia , Hills, Danny
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Journal of Nursing Management Vol. 30, no. 8 (2022), p. 4221-4233
- Full Text:
- Reviewed:
- Description: Aim: This scoping review aimed to identify the existing evidence on how nurse leaders promote and maintain civility amongst nurses in health care settings. Background: Research on managing workplace incivility in nursing, a prevalent and concerning issue worldwide, recommends nurse leaders to command cultural change through strong leadership and civility interventions. However, there is very little empirical evidence summarizing and analysing how nurse leaders pragmatically achieve civility, and combat workplace incivility, in the health care setting. Evaluation: A scoping review was undertaken using the electronic databases CINAHL, Emerald Insight, MEDLINE, PsychINFO, PubMed and Scopus. Google Scholar was used to search for grey literature. Key issues: The eight studies included in this review describe how nurse leaders promote and maintain civility under four key themes: (1) creating a shared vision, (2) educating self and others, (3) fostering accountability and (4) providing support. Conclusion: The review provides an overview of commonly used strategies and actions that pragmatically promote and maintain civility in the health care setting by nurse leaders, while also highlighting areas of future research needed to strengthen the evidence base. Implications for Nursing Management: It is important for nurse leaders to gain an understanding of evidence-based practices when addressing workplace incivility in order to address this prevailing problem for the future and safety of nurses moving forward. © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.
Surgical consent and the importance of a substitute decision-maker : a case study
- Authors: Gilbert, Julia , Gillespie, Brigid
- Date: 2017
- Type: Text , Journal article , Review
- Relation: ACORN Vol. 30, no. 1 (2017), p. 15-19
- Full Text:
- Reviewed:
- Description: At law, all individuals are presumed to have the legal capacity to provide consent or refusal of treatment unless there are clinical indications of cognitive impairment. Once concerns are raised regarding the ability of an individual to provide valid consent for a surgical procedure, the use of a substitute decision-maker may be necessary. In this paper, we present an analysis of a clinical case study to illustrate the principles of valid consent. As part of the analysis, we discuss the issues relating to obtaining valid consent for an operative surgical procedure from an elderly client with obvious cognitive impairment. We also explore the role of a substitute decision-maker to obtain the requisite valid consent.
'When no means no' - adolescent right to refuse an elective surgical procedure : a case study
- Authors: Gilbert, Julia , Gillespie, Brigid
- Date: 2017
- Type: Text , Journal article , Review
- Relation: ACORN Vol. 30, no. 2 (2017), p. 33-36
- Full Text:
- Reviewed:
- Description: At law, adults are presumed to have legal competency to provide consent for or refusal to consent to health care treatments unless they have cognitive impairment. But what of the adolescent who is, at law, a child but who refuses to undergo elective surgical treatment? This paper discusses the issues surrounding the case of Keith, a 14-year-old boy with ulcerative colitis, who refuses consent to undergo an elective ileostomy.
Acute neurological conditions
- Authors: Gilbert, Amali , Ford, Leeanne , Gilbert, Julia , Reshamwala, Reshamwala , Todorovic, Michael
- Date: 2018
- Type: Text , Book chapter
- Relation: Acute Care Nursing Chapter 8 p. 145-167
- Full Text: false
- Reviewed:
- Description: Neurological conditions are diseases or conditions affecting the central and peripheral nervous system, caused by illness or injury and resulting in physical and/or psychological symptoms. Neurological conditions are a primary contributor to disability, are often incurable and worsen over time. For these reasons, neurological conditions are considered a significant global and economic public health burden (Gaskin et al., 2017). Acute neurological disorders are not specific to a certain demographic, and can impact people of all ages, irrespective of gender or ethnicity. The patient presenting with an acute neurological condition represents a unique nursing challenge, with the condition often impacting the person’s quality of life. This impact can be significantly greater if disability is acquired at a young age. © Cambridge University Press 2018.
Acute endocrine conditions
- Authors: Latimer, Sharon , Barton, Matthew , Ford, Leeane , Gilbert, Julia , Sein, Nang
- Date: 2018
- Type: Text , Book chapter
- Relation: Acute Care Nursing Chapter 10 p. 190-211
- Full Text: false
- Reviewed:
- Description: Acute endocrine conditions such as diabetes and thyroid disease are potentially life threatening, with high mortality rates if they are not detected and treated rapidly. During 2014– 15, the prevalence of diabetes among the Australian population was 5.1 per cent, with a mortality rate of 16.3 deaths per 100 000 people (ABS, 2016). Yet for the same period, the mortality rate among Aboriginal and Torres Strait Islander Australians was almost five times higher (76.9 deaths per 100 000 people) (ABS, 2016). The treatment and management of acute endocrine conditions is complex, and requires an individualised approach (Diabetes Australia, 2015a). A multidisciplinary healthcare team is needed to manage these patients, and nurses play a vital role. This chapter discusses the incidence, presentation, clinical manifestations and treatment of the following acute endocrine conditions: diabetic ketoacidosis, hypoglycaemia, adrenal crisis, hypothyroidism and thyrotoxicosis. In addition, the concepts of patient-centred care and the nurse’s role in collaborative care for patients with acute endocrine conditions are discussed. © Cambridge University Press 2018.
Admitting and assessing medical and surgical clients
- Authors: Gilbert, Julia , Peddle, Monica , Reisenhofer, Sonia , Needham, Judith , Deravin, Linda
- Date: 2018
- Type: Text , Book chapter
- Relation: Acute Care Nursing Chapter 2 p. 18-41
- Full Text: false
- Reviewed:
- Description: This chapter discusses the admission and assessment of medical and surgical patients. It covers the process involved in admission and assessment of these acute clients and explains the concept of risk management, how important it is to patient safety and strategies that can be incorporated to increase patient safety and reduce risks. This is followed by a discussion about critical thinking and how it informs clinical decision-making. The role of the nurse is discussed in relation to patient-centred care, interpretation of diagnostic tests and administration of medication. The chapter concludes with a discussion of the discharge of acute clients, and how this requires consideration of social, cultural, physical and psychological factors. © Cambridge University Press 2018.