The impact of web-based and face-to-face simulation on patient deterioration and patient safety : Protocol for a multi-site multi-method design
- Cooper, Simon J., Kinsman, Leigh, Chung, Catherine, Cant, Robyn, Boyle, Jayne, Bull, Loretta, Cameron, Amanda, Connell, Cliff, Kim, Jeong-Ah, McInnes, Denise, McKay, Angela, Nankervis, Katrina, Penz, Erika, Rotter, Thomas
- Authors: Cooper, Simon J. , Kinsman, Leigh , Chung, Catherine , Cant, Robyn , Boyle, Jayne , Bull, Loretta , Cameron, Amanda , Connell, Cliff , Kim, Jeong-Ah , McInnes, Denise , McKay, Angela , Nankervis, Katrina , Penz, Erika , Rotter, Thomas
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 16, no. 1 (2016), p. 1-8
- Full Text:
- Reviewed:
- Description: Background: There are international concerns in relation to the management of patient deterioration which has led to a body of evidence known as the 'failure to rescue' literature. Nursing staff are known to miss cues of deterioration and often fail to call for assistance. Medical Emergency Teams (Rapid Response Teams) do improve the management of acutely deteriorating patients, but first responders need the requisite skills to impact on patient safety. Methods/design: In this study we aim to address these issues in a mixed methods interventional trial with the objective of measuring and comparing the cost and clinical impact of face-to-face and web-based simulation programs on the management of patient deterioration and related patient outcomes. The education programs, known as 'FIRST2ACT', have been found to have an impact on education and will be tested in four hospitals in the State of Victoria, Australia. Nursing staff will be trained in primary (the first 8 min) responses to emergencies in two medical wards using a face-to-face approach and in two medical wards using a web-based version FIRST2ACTWeb. The impact of these interventions will be determined through quantitative and qualitative approaches, cost analyses and patient notes review (time series analyses) to measure quality of care and patient outcomes. Discussion: In this 18 month study it is hypothesised that both simulation programs will improve the detection and management of deteriorating patients but that the web-based program will have lower total costs. The study will also add to our overall understanding of the utility of simulation approaches in the preparation of nurses working in hospital wards. (ACTRN12616000468426, retrospectively registered 8.4.2016). © 2016 The Author(s).
- Authors: Cooper, Simon J. , Kinsman, Leigh , Chung, Catherine , Cant, Robyn , Boyle, Jayne , Bull, Loretta , Cameron, Amanda , Connell, Cliff , Kim, Jeong-Ah , McInnes, Denise , McKay, Angela , Nankervis, Katrina , Penz, Erika , Rotter, Thomas
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 16, no. 1 (2016), p. 1-8
- Full Text:
- Reviewed:
- Description: Background: There are international concerns in relation to the management of patient deterioration which has led to a body of evidence known as the 'failure to rescue' literature. Nursing staff are known to miss cues of deterioration and often fail to call for assistance. Medical Emergency Teams (Rapid Response Teams) do improve the management of acutely deteriorating patients, but first responders need the requisite skills to impact on patient safety. Methods/design: In this study we aim to address these issues in a mixed methods interventional trial with the objective of measuring and comparing the cost and clinical impact of face-to-face and web-based simulation programs on the management of patient deterioration and related patient outcomes. The education programs, known as 'FIRST2ACT', have been found to have an impact on education and will be tested in four hospitals in the State of Victoria, Australia. Nursing staff will be trained in primary (the first 8 min) responses to emergencies in two medical wards using a face-to-face approach and in two medical wards using a web-based version FIRST2ACTWeb. The impact of these interventions will be determined through quantitative and qualitative approaches, cost analyses and patient notes review (time series analyses) to measure quality of care and patient outcomes. Discussion: In this 18 month study it is hypothesised that both simulation programs will improve the detection and management of deteriorating patients but that the web-based program will have lower total costs. The study will also add to our overall understanding of the utility of simulation approaches in the preparation of nurses working in hospital wards. (ACTRN12616000468426, retrospectively registered 8.4.2016). © 2016 The Author(s).
Barriers and enablers to the delivery of psychological care in the management of patients with type 2 diabetes mellitus in China : a qualitative study using the theoretical domains framework
- Chapman, Anna, Yang, Hui, Thomas, Shane, Searle, Kendall, Browning, Colette
- Authors: Chapman, Anna , Yang, Hui , Thomas, Shane , Searle, Kendall , Browning, Colette
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 16, no. 1 (2016), p.
- Full Text:
- Reviewed:
- Description: Background: China has the largest number of type 2 diabetes mellitus (T2DM) cases globally and individuals with T2DM have an increased risk of developing mental health disorders and functional problems. Despite guidelines recommending that psychological care be delivered in conjunction with standard T2DM care; psychological care is not routinely delivered in China. Community Health Centre (CHC) doctors play a key role in the management of patients with T2DM in China. Understanding the behavioural determinants of CHC doctors in the implementation of psychological care recommendations allows for the design of targeted and culturally appropriate interventions. As such, this study aimed to examine barriers and enablers to the delivery of psychological care to patients with T2DM from the perspective of CHC doctors in China. Methods: Two focus groups were conducted with 23 CHC doctors from Shenzhen, China. The discussion guide applied the Theoretical Domains Framework (TDF) that examines current practice and identifies key barriers and enablers perceived to influence practice. Focus groups were conducted with an interpreter, and were digitally recorded and transcribed. Two researchers independently coded transcripts into pre-defined themes using deductive thematic analysis. Results: Barriers and enablers perceived by doctors as being relevant to the delivery of psychological care for patients with T2DM were primarily categorised within eight TDF domains. Key barriers included: CHC doctors' knowledge and skills; time constraints; and absence of financial incentives. Other barriers included: societal perception that treating psychological aspects of health is less important than physical health; lack of opinion leaders; doctors' intentional disregard of psychological care; and doubts regarding the efficacy of psychological care. In contrast, perceived enablers included: Training of CHC doctors in psychological skills; identification of afternoon/evening clinic times when recommendations could be implemented; introduction of financial incentives; and the creation of a professional role (e.g. diabetes educator), that could implement psychological care recommendations to patients with T2DM. © 2016 Chapman et al..
- Authors: Chapman, Anna , Yang, Hui , Thomas, Shane , Searle, Kendall , Browning, Colette
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 16, no. 1 (2016), p.
- Full Text:
- Reviewed:
- Description: Background: China has the largest number of type 2 diabetes mellitus (T2DM) cases globally and individuals with T2DM have an increased risk of developing mental health disorders and functional problems. Despite guidelines recommending that psychological care be delivered in conjunction with standard T2DM care; psychological care is not routinely delivered in China. Community Health Centre (CHC) doctors play a key role in the management of patients with T2DM in China. Understanding the behavioural determinants of CHC doctors in the implementation of psychological care recommendations allows for the design of targeted and culturally appropriate interventions. As such, this study aimed to examine barriers and enablers to the delivery of psychological care to patients with T2DM from the perspective of CHC doctors in China. Methods: Two focus groups were conducted with 23 CHC doctors from Shenzhen, China. The discussion guide applied the Theoretical Domains Framework (TDF) that examines current practice and identifies key barriers and enablers perceived to influence practice. Focus groups were conducted with an interpreter, and were digitally recorded and transcribed. Two researchers independently coded transcripts into pre-defined themes using deductive thematic analysis. Results: Barriers and enablers perceived by doctors as being relevant to the delivery of psychological care for patients with T2DM were primarily categorised within eight TDF domains. Key barriers included: CHC doctors' knowledge and skills; time constraints; and absence of financial incentives. Other barriers included: societal perception that treating psychological aspects of health is less important than physical health; lack of opinion leaders; doctors' intentional disregard of psychological care; and doubts regarding the efficacy of psychological care. In contrast, perceived enablers included: Training of CHC doctors in psychological skills; identification of afternoon/evening clinic times when recommendations could be implemented; introduction of financial incentives; and the creation of a professional role (e.g. diabetes educator), that could implement psychological care recommendations to patients with T2DM. © 2016 Chapman et al..
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