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Howard S Gordon - One of the best experts on this subject based on the ideXlab platform.
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The clinical context and Patient Participation in post-diagnostic consultations.
Patient education and counseling, 2006Co-Authors: Richard L Street, Howard S GordonAbstract:Although Patient Participation is an important feature of Patient-centered health care, few studies have examined how the clinical context affects Patient involvement in medical encounters. This investigation examined the way Patients communicate with physicians in two diverse post-diagnostic settings, post-angiogram consultations and initial lung cancer visits. From transcripts and audiorecordings of post-angiogram consultations (n=88) and initial lung cancer visits (n=62) within a VA hospital in the United States, three measures of Patient Participation were coded--number of active Participation behaviors (questions, acts of assertiveness, and expressions of concern), proportion of Patients' utterances in the form of active Participation, and conversational involvement (ratio of Patient utterances to physician plus Patient utterances). Mixed linear regression procedures assessed the independent effects of the clinical setting, physicians' facilitative communication (partnership-building and supportive talk), and Patients' age, education, and ethnicity on Patient Participation. Not only was their less talk in the post-angiogram consultations compared with the lung cancer visits, heart Patients also were less conversationally involved (accounted for 25% of the talk) than were lung cancer Patients (45% of the talk) and their doctors used proportionally less facilitative talk than did the lung cancer physicians. In both settings, Patients were more conversationally engaged when proportionally more of the physicians' talk was facilitative. The clinical context has a profound effect on Patient Participation. However, within individual settings, physicians can increase Patient involvement by using partnering and supportive communication. Clinicians and administrators should assess clinical practices that restrict Patient involvement in ways that could affect quality of decision-making.
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The clinical context and Patient Participation in post-diagnostic consultations.
Patient Education and Counseling, 2006Co-Authors: Richard L Street, Howard S GordonAbstract:Abstract Objective Although Patient Participation is an important feature of Patient-centered health care, few studies have examined how the clinical context affects Patient involvement in medical encounters. This investigation examined the way Patients communicate with physicians in two diverse post-diagnostic settings, post-angiogram consultations and initial lung cancer visits. Methods From transcripts and audiorecordings of post-angiogram consultations (n = 88) and initial lung cancer visits (n = 62) within a VA hospital in the United States, three measures of Patient Participation were coded—number of active Participation behaviors (questions, acts of assertiveness, and expressions of concern), proportion of Patients’ utterances in the form of active Participation, and conversational involvement (ratio of Patient utterances to physician plus Patient utterances). Mixed linear regression procedures assessed the independent effects of the clinical setting, physicians’ facilitative communication (partnership-building and supportive talk), and Patients’ age, education, and ethnicity on Patient Participation. Results Not only was their less talk in the post-angiogram consultations compared with the lung cancer visits, heart Patients also were less conversationally involved (accounted for 25% of the talk) than were lung cancer Patients (45% of the talk) and their doctors used proportionally less facilitative talk than did the lung cancer physicians. In both settings, Patients were more conversationally engaged when proportionally more of the physicians’ talk was facilitative. Conclusions The clinical context has a profound effect on Patient Participation. However, within individual settings, physicians can increase Patient involvement by using partnering and supportive communication. Practice implications Clinicians and administrators should assess clinical practices that restrict Patient involvement in ways that could affect quality of decision-making.
Wendy Chaboyer - One of the best experts on this subject based on the ideXlab platform.
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Patient Participation in nursing bedside handover a systematic mixed methods review
International Journal of Nursing Studies, 2018Co-Authors: Georgia Tobiano, Tracey Bucknall, Ishtar Sladdin, Jennifer A Whitty, Wendy ChaboyerAbstract:Abstract Background Numerous reviews of nursing handover have been undertaken, but none have focused on the Patients' role. Objectives To explore how Patient Participation in nursing shift-to-shift bedside handover can be enacted. Design Systematic mixed- methods review. Data sources Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching. To be included, papers had to either be research or quality improvement (QI) projects focusing on the Patient role. Fifty-four articles were retrieved, including 21 studies and 25 QI projects. Review methods Screening, data extraction and quality appraisal was undertaken systematically by two reviewers. Research studies and QI projects were synthesised separately using thematic synthesis, then the results of this synthesis were combined using a mixed-method synthesis table. Results Segregated synthesis of research of Patients' perceptions revealed two contrasting categories; Patient-centred handover and nurse-centred handover. Segregated synthesis of research of nurses' perceptions included three categories: viewing the Patient as an information resource; dealing with confidential and sensitive information; and enabling Patient Participation. The segregated synthesis of QI projects included two categories: nurse barrier to enacting Patient Participation in bedside handover; and involving Patients in beside handover. Once segregated findings were configured, we discovered that the Patient's role in bedside handover involves contributing clinical information related to their care or progress, which may influence Patient safety. Barriers related to nurses' concerns for the consequences of encouraging Patient Participation, worries for sharing confidential and sensitive information and feeling hesitant in changing their handover methods. The way nurses approach Patients, and how Patient-centred they are, constitute further potential barriers. Strategies to improve Patient Participation in handover include training nurses, making handovers predictable for Patients and involving both Patients and nurses throughout the change process. Conclusions Using research and QI projects allowed diverse findings to expand each other and identify gaps between research and heuristic knowledge. Our review showed the tension between standardising handovers and making them predictable for Patient Participation, while promoting tailored and flexible handovers. Further investigation of this issue is required, to understand how to train nurses and Patient views. Many barriers and strategies identified were from QI projects and the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure high quality QI projects.
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Registered Nurses' experiences of Patient Participation in hospital care: supporting and hindering factors Patient Participation in care.
Scandinavian journal of caring sciences, 2017Co-Authors: Lena Oxelmark, Tracey Bucknall, Wendy Chaboyer, Kerstin Ulin, Mona RingdalAbstract:Background Promoting Patient Participation in care is an international priority identified by the World Health Organization and various national bodies around the world and an important aspect of person-centred care. Aim The aim of this study was to describe Registered Nurses’ experiences with Patient Participation in nursing care including their barriers and facilitators for Participation. Method The study setting was a University Hospital in Sweden. Interviews were conducted with twenty Registered Nurses working at medical wards in 2013. Thematic data analysis was used to analyse the transcribed interview data. Results Twenty nurses from four wards in two hospitals were included. Five themes emerged from the analysis including listening to the Patient, engaging the Patient, relinquishing some responsibility, sharing power and partnering with Patients. The core theme ‘partnering with Patients’ was enacted when nurses listened to and engaged Patients and when they relinquished responsibility and shared power with Patients. In addition, hindering and facilitating factors to Participation were identified, such as Patients wanted to take on a passive role, lack of teamwork which participants understood would enhance interprofessional understanding and improve Patient safety. Patient Participation was hindered by medical jargon during the ward round, there was a risk of staff talking over Patients’ heads but sometimes inevitable having conversations at the Patient's bedside. However, nurses preferred important decisions to be made away from bedside. Conclusions It all came down to partnering with the Patient and participants described how they made an effort to respect the Patients’ view and accept Patient as a part of the care team. Identified hindering factors for Participation were lack of teamwork, Patients’ taking on passive roles and communication during ward rounds having conversations at the Patient's bedside. Nurses wished for a change but lacked strategies on how. Nurses preferred important decisions to be made away from bedside.
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Activities Patients and Nurses Undertake to Promote Patient Participation.
Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, 2016Co-Authors: Georgia Tobiano, Tracey Bucknall, Andrea Marshall, Wendy ChaboyerAbstract:Purpose To describe and understand activities Patients and nurses undertake to enact Patient Participation in nursing care. Design This observational study was conducted on two medical units at a public hospital in Australia. Twenty-eight nurse–Patient dyads were observed for at least 4 hr. Data were collected from November 2013 to February 2014. Methods Field notes were collected and were analyzed both inductively and deductively. Findings Nurse–Patient interactions promoted Patient Participation through dialogue and knowledge sharing. Less evident was Patient involvement in planning or self-care. Nurses exerted control over Patient care, which influenced the extent of Patient Participation. Conclusions Patient Participation appears to be difficult to enact. Nurses’ controlling approach, influenced by organizational issues, was in conflict with a Patient-centered approach to care. Nurse–Patient communication is one aspect of Patient-centered care enacted more frequently. Clinical Relevance Nurses may benefit from strategies at the individual and organizational level to enhance their Patient-centered practices. Fostering nurses’ communication may enhance Patient-centered practices in hospitals.
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Nurses' views of Patient Participation in nursing care.
Journal of advanced nursing, 2015Co-Authors: Georgia Tobiano, Tracey Bucknall, Andrea Marshall, Jessica Guinane, Wendy ChaboyerAbstract:AIMS: To explore nurses' views of Patient Participation in nursing care on medical wards. BACKGROUND: Nurses have frequent contact with Patients, highlighting their potential role in enabling Patient Participation. However, some nurses' actions and attitudes act as barriers, failing to achieve core requirements of Patient Participation. Discovering nurses' views may assist in developing strategies to encourage Patient Participation in hospitals. DESIGN: Interpretive study. METHODS: Twenty nurses were recruited from four medical wards, located in two Australian hospitals. In-depth semi-structured interviews were conducted between November 2013-March 2014 and analysed using content analysis. FINDINGS: Five categories emerged from the nurses' views. The first category, acknowledging Patients as partners, showed nurses respected Patients as legitimate participants. In the second category, managing risk, nurses emphasized the need to monitor Participation to ensure rules and Patient safety were maintained. Enabling Participation was the third category, which demonstrated nurses' strategies that enhanced Patients' Participation. The fourth category was hindering Participation; encapsulating nurses' difficulty in engaging Patients with certain characteristics. In the final category, realizing Participation, nurses believed Patients could be involved in physical activities or clinical communication. CONCLUSION: Nurses have a crucial role in promoting Patient Participation. Through acknowledging and enabling Participation, nurses may facilitate Patient Participation in a range of nursing activities. The nurse's role in enacting Participation is complex, having to accommodate each Patient's risks and characteristics, highlighting the need for good assessment skills. Education, policy and research strategies are essential to foster nurses' pivotal role in Patient Participation.
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Patient Participation in nursing care on medical wards: An integrative review
International journal of nursing studies, 2015Co-Authors: Georgia Tobiano, Tracey Bucknall, Andrea Marshall, Wendy ChaboyerAbstract:Abstract Background Patient Participation is a way for Patients to engage in their nursing care. In view of the possible link between Patient Participation and safety, there is a need for an updated review to assess Patient Participation in nursing care. Objectives To investigate Patients' and nurses' perceptions of and behaviours towards Patient Participation in nursing care in the context of hospital medical wards. Design Integrative review. Data sources Three search strategies were employed in August 2013; a computerised database search of Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Medline and PsychINFO; reference lists were hand-searched; and forward citation searching was executed. Review methods After reviewing the studies, extracting study data and completing summary tables the methodological quality was assessed using the Mixed-Methods Assessment Tool by two reviewers. Reviewers met then to discuss discrepancies as well as the overall strengths and limitations of the studies. Discrepancies were overcome through consensus or a third reviewer adjudicated the issue. Within and across study analysis and synthesis of the findings sections was undertaken using thematic synthesis. Results Eight studies met inclusion criteria. Four themes were identified – enacting Participation, challenges to Participation, promoting Participation and types of Participation. Most studies included were conducted in Europe. The majority of studies used qualitative methodologies, with all studies sampling Patients; nurses were included in three studies. Data were largely collected using self-reported perceptions; two studies included observational data. Methodological issues included a lack of reflexivity, un-validated data collection tools, sampling issues and low response rates. Conclusions On medical wards, Patients and nurses desire, perceive or enact Patient Participation passively. Challenging factors for Patient Participation include Patients' willingness, nurses' approach and confusion around expectations and roles. Information-sharing was identified as an activity that promotes Patient Participation, suggesting nurses encourage active communication with Patients in practice. Involving Patients in assessment and care planning may also enhance Patient Participation. For education, enhancing nurses' understanding of the attributes of Patient Participation, as well as Patient-centred care approaches may be beneficial for medical ward nurses. From here, researchers need to examine ways to overcome the barriers to Patient Participation; further nurse participants and observational data is required on medical wards.
Richard L Street - One of the best experts on this subject based on the ideXlab platform.
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The clinical context and Patient Participation in post-diagnostic consultations.
Patient education and counseling, 2006Co-Authors: Richard L Street, Howard S GordonAbstract:Although Patient Participation is an important feature of Patient-centered health care, few studies have examined how the clinical context affects Patient involvement in medical encounters. This investigation examined the way Patients communicate with physicians in two diverse post-diagnostic settings, post-angiogram consultations and initial lung cancer visits. From transcripts and audiorecordings of post-angiogram consultations (n=88) and initial lung cancer visits (n=62) within a VA hospital in the United States, three measures of Patient Participation were coded--number of active Participation behaviors (questions, acts of assertiveness, and expressions of concern), proportion of Patients' utterances in the form of active Participation, and conversational involvement (ratio of Patient utterances to physician plus Patient utterances). Mixed linear regression procedures assessed the independent effects of the clinical setting, physicians' facilitative communication (partnership-building and supportive talk), and Patients' age, education, and ethnicity on Patient Participation. Not only was their less talk in the post-angiogram consultations compared with the lung cancer visits, heart Patients also were less conversationally involved (accounted for 25% of the talk) than were lung cancer Patients (45% of the talk) and their doctors used proportionally less facilitative talk than did the lung cancer physicians. In both settings, Patients were more conversationally engaged when proportionally more of the physicians' talk was facilitative. The clinical context has a profound effect on Patient Participation. However, within individual settings, physicians can increase Patient involvement by using partnering and supportive communication. Clinicians and administrators should assess clinical practices that restrict Patient involvement in ways that could affect quality of decision-making.
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The clinical context and Patient Participation in post-diagnostic consultations.
Patient Education and Counseling, 2006Co-Authors: Richard L Street, Howard S GordonAbstract:Abstract Objective Although Patient Participation is an important feature of Patient-centered health care, few studies have examined how the clinical context affects Patient involvement in medical encounters. This investigation examined the way Patients communicate with physicians in two diverse post-diagnostic settings, post-angiogram consultations and initial lung cancer visits. Methods From transcripts and audiorecordings of post-angiogram consultations (n = 88) and initial lung cancer visits (n = 62) within a VA hospital in the United States, three measures of Patient Participation were coded—number of active Participation behaviors (questions, acts of assertiveness, and expressions of concern), proportion of Patients’ utterances in the form of active Participation, and conversational involvement (ratio of Patient utterances to physician plus Patient utterances). Mixed linear regression procedures assessed the independent effects of the clinical setting, physicians’ facilitative communication (partnership-building and supportive talk), and Patients’ age, education, and ethnicity on Patient Participation. Results Not only was their less talk in the post-angiogram consultations compared with the lung cancer visits, heart Patients also were less conversationally involved (accounted for 25% of the talk) than were lung cancer Patients (45% of the talk) and their doctors used proportionally less facilitative talk than did the lung cancer physicians. In both settings, Patients were more conversationally engaged when proportionally more of the physicians’ talk was facilitative. Conclusions The clinical context has a profound effect on Patient Participation. However, within individual settings, physicians can increase Patient involvement by using partnering and supportive communication. Practice implications Clinicians and administrators should assess clinical practices that restrict Patient involvement in ways that could affect quality of decision-making.
Georgia Tobiano - One of the best experts on this subject based on the ideXlab platform.
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Patient Participation in nursing bedside handover a systematic mixed methods review
International Journal of Nursing Studies, 2018Co-Authors: Georgia Tobiano, Tracey Bucknall, Ishtar Sladdin, Jennifer A Whitty, Wendy ChaboyerAbstract:Abstract Background Numerous reviews of nursing handover have been undertaken, but none have focused on the Patients' role. Objectives To explore how Patient Participation in nursing shift-to-shift bedside handover can be enacted. Design Systematic mixed- methods review. Data sources Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching. To be included, papers had to either be research or quality improvement (QI) projects focusing on the Patient role. Fifty-four articles were retrieved, including 21 studies and 25 QI projects. Review methods Screening, data extraction and quality appraisal was undertaken systematically by two reviewers. Research studies and QI projects were synthesised separately using thematic synthesis, then the results of this synthesis were combined using a mixed-method synthesis table. Results Segregated synthesis of research of Patients' perceptions revealed two contrasting categories; Patient-centred handover and nurse-centred handover. Segregated synthesis of research of nurses' perceptions included three categories: viewing the Patient as an information resource; dealing with confidential and sensitive information; and enabling Patient Participation. The segregated synthesis of QI projects included two categories: nurse barrier to enacting Patient Participation in bedside handover; and involving Patients in beside handover. Once segregated findings were configured, we discovered that the Patient's role in bedside handover involves contributing clinical information related to their care or progress, which may influence Patient safety. Barriers related to nurses' concerns for the consequences of encouraging Patient Participation, worries for sharing confidential and sensitive information and feeling hesitant in changing their handover methods. The way nurses approach Patients, and how Patient-centred they are, constitute further potential barriers. Strategies to improve Patient Participation in handover include training nurses, making handovers predictable for Patients and involving both Patients and nurses throughout the change process. Conclusions Using research and QI projects allowed diverse findings to expand each other and identify gaps between research and heuristic knowledge. Our review showed the tension between standardising handovers and making them predictable for Patient Participation, while promoting tailored and flexible handovers. Further investigation of this issue is required, to understand how to train nurses and Patient views. Many barriers and strategies identified were from QI projects and the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure high quality QI projects.
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Activities Patients and Nurses Undertake to Promote Patient Participation.
Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, 2016Co-Authors: Georgia Tobiano, Tracey Bucknall, Andrea Marshall, Wendy ChaboyerAbstract:Purpose To describe and understand activities Patients and nurses undertake to enact Patient Participation in nursing care. Design This observational study was conducted on two medical units at a public hospital in Australia. Twenty-eight nurse–Patient dyads were observed for at least 4 hr. Data were collected from November 2013 to February 2014. Methods Field notes were collected and were analyzed both inductively and deductively. Findings Nurse–Patient interactions promoted Patient Participation through dialogue and knowledge sharing. Less evident was Patient involvement in planning or self-care. Nurses exerted control over Patient care, which influenced the extent of Patient Participation. Conclusions Patient Participation appears to be difficult to enact. Nurses’ controlling approach, influenced by organizational issues, was in conflict with a Patient-centered approach to care. Nurse–Patient communication is one aspect of Patient-centered care enacted more frequently. Clinical Relevance Nurses may benefit from strategies at the individual and organizational level to enhance their Patient-centered practices. Fostering nurses’ communication may enhance Patient-centered practices in hospitals.
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Patient Participation in Nursing Care: A Focused Ethnography
2016Co-Authors: Georgia TobianoAbstract:Patient-centred care has been recognised internationally as a way Patients can participate in their nursing care to potentially improve their safety, yet widespread understanding of Patient Participation and ways to promote it is lacking. Further, nurses’ behaviours sometimes conflict with their reported support for Patient Participation. The aim of this study was to understand Patient Participation in nursing care in medical wards and the barriers to and facilitators of Patient Participation. This study was a focused ethnography. Two hospitals participated in the study. Site 1 was located in Queensland and catered for public Patients, while Site 2 was located in Victoria and catered for private Patients. The setting for this study was four medical wards, two from each hospital. Patients and nurses were observed in practice and participated in semi-structured interviews. Observational field notes were analysed using both deductive and inductive content analysis. Interviews were transcribed and analysed using inductive content analysis. Deductive analysis of observations of practice showed that the most frequent types of Participation were in the categories ‘having dialogue with health care staff’ and ‘sharing knowledge’. Patients participated less frequently in the categories ‘partaking in planning’ and ‘managing self-care’. Inductive analysis of field notes demonstrated that nurses exerted control over care, evident in the category ‘maintaining control of work’. Findings from 20 Patient interviews, revealed four categories. In the category ‘valuing Participation’ Patients spoke about wanting to participate and seeing it as beneficial. The categories ‘exchanging intelligence’ and ‘on the lookout’, were ways Patients reported participating in care. The final category ‘power imbalance’, revealed Patients’ difficulty in enacting Participation.
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Nurses' views of Patient Participation in nursing care.
Journal of advanced nursing, 2015Co-Authors: Georgia Tobiano, Tracey Bucknall, Andrea Marshall, Jessica Guinane, Wendy ChaboyerAbstract:AIMS: To explore nurses' views of Patient Participation in nursing care on medical wards. BACKGROUND: Nurses have frequent contact with Patients, highlighting their potential role in enabling Patient Participation. However, some nurses' actions and attitudes act as barriers, failing to achieve core requirements of Patient Participation. Discovering nurses' views may assist in developing strategies to encourage Patient Participation in hospitals. DESIGN: Interpretive study. METHODS: Twenty nurses were recruited from four medical wards, located in two Australian hospitals. In-depth semi-structured interviews were conducted between November 2013-March 2014 and analysed using content analysis. FINDINGS: Five categories emerged from the nurses' views. The first category, acknowledging Patients as partners, showed nurses respected Patients as legitimate participants. In the second category, managing risk, nurses emphasized the need to monitor Participation to ensure rules and Patient safety were maintained. Enabling Participation was the third category, which demonstrated nurses' strategies that enhanced Patients' Participation. The fourth category was hindering Participation; encapsulating nurses' difficulty in engaging Patients with certain characteristics. In the final category, realizing Participation, nurses believed Patients could be involved in physical activities or clinical communication. CONCLUSION: Nurses have a crucial role in promoting Patient Participation. Through acknowledging and enabling Participation, nurses may facilitate Patient Participation in a range of nursing activities. The nurse's role in enacting Participation is complex, having to accommodate each Patient's risks and characteristics, highlighting the need for good assessment skills. Education, policy and research strategies are essential to foster nurses' pivotal role in Patient Participation.
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Patient Participation in nursing care on medical wards: An integrative review
International journal of nursing studies, 2015Co-Authors: Georgia Tobiano, Tracey Bucknall, Andrea Marshall, Wendy ChaboyerAbstract:Abstract Background Patient Participation is a way for Patients to engage in their nursing care. In view of the possible link between Patient Participation and safety, there is a need for an updated review to assess Patient Participation in nursing care. Objectives To investigate Patients' and nurses' perceptions of and behaviours towards Patient Participation in nursing care in the context of hospital medical wards. Design Integrative review. Data sources Three search strategies were employed in August 2013; a computerised database search of Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Medline and PsychINFO; reference lists were hand-searched; and forward citation searching was executed. Review methods After reviewing the studies, extracting study data and completing summary tables the methodological quality was assessed using the Mixed-Methods Assessment Tool by two reviewers. Reviewers met then to discuss discrepancies as well as the overall strengths and limitations of the studies. Discrepancies were overcome through consensus or a third reviewer adjudicated the issue. Within and across study analysis and synthesis of the findings sections was undertaken using thematic synthesis. Results Eight studies met inclusion criteria. Four themes were identified – enacting Participation, challenges to Participation, promoting Participation and types of Participation. Most studies included were conducted in Europe. The majority of studies used qualitative methodologies, with all studies sampling Patients; nurses were included in three studies. Data were largely collected using self-reported perceptions; two studies included observational data. Methodological issues included a lack of reflexivity, un-validated data collection tools, sampling issues and low response rates. Conclusions On medical wards, Patients and nurses desire, perceive or enact Patient Participation passively. Challenging factors for Patient Participation include Patients' willingness, nurses' approach and confusion around expectations and roles. Information-sharing was identified as an activity that promotes Patient Participation, suggesting nurses encourage active communication with Patients in practice. Involving Patients in assessment and care planning may also enhance Patient Participation. For education, enhancing nurses' understanding of the attributes of Patient Participation, as well as Patient-centred care approaches may be beneficial for medical ward nurses. From here, researchers need to examine ways to overcome the barriers to Patient Participation; further nurse participants and observational data is required on medical wards.
Mari Kangasniemi - One of the best experts on this subject based on the ideXlab platform.
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Patient Participation in pro re nata medication in psychiatric inPatient settings: An integrative review.
International journal of mental health nursing, 2017Co-Authors: Kirsi Hipp, Lauri Kuosmanen, Eila Repo-tiihonen, Minna Leinonen, Olavi Louheranta, Mari KangasniemiAbstract:Pro re nata (PRN) medication is widely used and studied in psychiatric care, but our knowledge about Patient Participation in its administration is fragmented. The aim of this integrative review was to describe and synthesize previous knowledge of Patient Participation in PRN in psychiatric inPatient settings. We conducted both electronic and manual searches, using the CINAHL, Scopus, PsycINFO, and PubMed databases, and eight scientific journals. Searches were limited to the English language, to the years 2006-2016, and to selected papers using inclusion, exclusion, and quality criteria. We identified 16 relevant papers, and these showed that Patient Participation included Patient-related starting points, including the Patients' willingness to participate and their knowledge of the medication. The Patients' Participation in PRN practices was demonstrated by the opportunity to request PRN and to refuse any PRN that was offered. Patient Participation was shown to be linked to certain situations where PRN was recommended. The role that the professionals played in Patient Participation included interacting with Patients, providing counselling and alternatives for PRN. Our results also revealed that coercion was used administering PRN. The existing literature exposed challenges that need to be addressed if Patient Participation in the use of PRN medication is to be effectively achieved in psychiatric inPatient settings. Equal partnerships between Patients, nurses, and physicians are an essential part of this process, and further research into PRN medication is urgently needed, particularly studies that focus on Patients' experiences.
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Patient Participation in Patient safety and nursing input a systematic review
Journal of Clinical Nursing, 2015Co-Authors: Mojtaba Vaismoradi, Sue Jordan, Mari KangasniemiAbstract:Aims and objectives This systematic review aims to synthesise the existing research on how Patients participate in Patient safety initiatives. Background Ambiguities remain about how Patients participate in routine measures designed to promote Patient safety. Design Systematic review using integrative methods. Methods Electronic databases were searched using keywords describing Patient involvement, nursing input and Patient safety initiatives to retrieve empirical research published between 2007 and 2013. Findings were synthesized using the theoretical domains of Vincent's framework for analysing risk and safety in clinical practice: “Patient”, “healthcare provider”, “task”, “work environment”, “organisation & management”. Results We identified 17 empirical research papers: four qualitative, one mixed-method and 12 quantitative designs. All 17 papers indicated that Patients can participate in safety initiatives. Conclusions Improving Patient Participation in Patient safety necessitates considering the Patient as a person, the nurse as healthcare provider, the task of Participation and the clinical environment. Patients' knowledge, health conditions, beliefs and experiences influence their decisions to engage in Patient safety initiatives. An important component of the management of long-term conditions is to ensure that Patients have sufficient knowledge to participate. Healthcare providers may need further professional development in Patient education and Patient care management to promote Patient involvement in Patient safety, and ensure that Patients understand that they are ‘allowed’ to inform nurses of adverse events or errors. A healthcare system characterised by Patient-centredness and mutual acknowledgement will support Patient Participation in safety practices. Further research is required to improve international knowledge of Patient Participation in Patient safety in different disciplines, contexts and cultures. Relevance to clinical practice Patients have a significant role to play in enhancing their own safety while receiving hospital care. This review offers a framework for clinicians to develop comprehensive practical guidelines to support Patient involvement in Patient safety.
