Should I report? A qualitative study of barriers to incident reporting among nurses working in nursing homes

Adverse events, errors and acts of inadequate care have been shown to occur quite frequently in hospitals, and there is growing evidence that this poor care may also occur in nursing homes. Based on hospital studies, we know that incidents are only reported to a limited extent and that there may be a high number of unrecorded cases. Moreover, little is known about the barriers to incident reporting in nursing homes compared to hospitals. Consequently, the aim of this study was to explore the barriers to incident reporting in nursing homes. Thematic analysis of 13 semi-structured interviews with nurses revealed that unclear outcomes, lack of support and culture, fear of vilification and conflicts, unclear routines, technological knowledge and confidence, time and degree of severity were the main drivers of not reporting incidents. These findings may be important in planning quality and safety improvement interventions in nursing homes.     

Perioperative nurses’ experiences of communication in a multicultural operating theatre: A qualitative study

AimTo explore the lived experiences of perioperative nurses in a multicultural operating theatre in Melbourne, Australia.BackgroundMulticulturalism has become the norm in the health workforce of several developed countries due mostly to immigration. Within an operating theatre setting where good communication is paramount, the presence of nurses and doctors from multiple cultures and different training backgrounds could pose a major challenge.MethodUsing a qualitative research methodology underpinned by phenomenology, we interviewed fourteen nurses from different sections of an operating theatre.ResultsFrom the lived experiences of the participants, difficulties in communication emerged as the major theme. Difficulties in communication affected patient care and the working atmosphere. In addition, social integration appeared to improve communication.ConclusionsAddressing the needs of patients from culturally and linguistically diverse backgrounds in the operating theatre continues to be challenging. However, developing a sense of camaraderie and fostering good relationships between staff through regular social gatherings can improve communication and the working atmosphere.     

Can nurses, working in the emergency department, independently clear cervical spines?: a review of the literature

The prompt clearance of a patient's cervical spine is extremely beneficial both to the patients and the department however correct guidelines and education must be established before this can be undertaken safely. This paper examines whether nurses given the appropriate training and education using appropriate diagnostic and clinical criteria can safely, effectively clear cervical spines without consulting a medical practitioner. The paper explores the use of the Nexus Guidelines [J.R. Hoffman, W.R. Mower, A.B. Wolfson, New England Journal of Medicine 343 (2) (2000) 94-99] as a clinical prediction tool and presents evidence for its use.     

Use of toys in hospitals: what are Brazilian nurses studying?

Care for the emotional needs of hospitalized children has had the attention of nursing professionals in Brazil, although not as a general rule. The chance to play is known as a relief from suffering, especially in childhood, which justifies the importance of this theme. This study had the objective of analyzing Brazilian nurses' academic production on the use of toys during the attention to children in hospitals in strictu sensu Graduate programs. Data were taken from Portal CAPES, CEPEn, IBICT and papers' references. Of the 15 theses/dissertations found in the literature only 14 are available; they were analyzed and comprise the corpus of this study. It was found that toys have been used mostly in pre and postsurgery, by Nursing professors, with preschool and school age children, parents and nurses. All of the works reinforce the positive results of toys' use. We recommend to pediatric nurses the use of toys in all institutions where children need care.     

Can a PC-based model assist the management of waiting lists? Observations from a case study.

Routine statistics provide only limited support to doctors and managers responsible for the management of surgical waiting lists. Therefore, a study developed a PC-based model that could assist medium-term planning activities that, for example, aim to reduce excessive waiting times. The model allows the user to create scenarios that describe possible future activity levels and calculates how these will affect waiting list behaviour. A key feature of the model is that it recognizes that a waiting list consists of different categories of patients that move through the list at different speeds. The model can be used with routinely available data. The model was tested at three sites where it proved capable of providing valuable insights and assisting doctors and managers to better understand waiting list dynamics. However, although the model quantified the changes required to reduce waiting times, the sites could not always implement these changes owing to resource constraints.     

Australian nurses in general practice,enabling the provision of cervical screening and well women’s health care services: a qualitative study

Background

The role of Australian general practice nurses (PNs) has developed exponentially since the introduction of service based funding in 2005. In particular, their role has expanded to include cervical screening and well women’s health care services provided under the supervision of a general practitioner (GP). While previous research identifies barriers to the provision of these services, this study sought to investigate enablers for nurse led care in this area.

Methods

A number of grounded theory methods including constantly comparing data, concurrent data collection and analysis and theoretical sampling are utilised in this qualitative, exploratory study. A purposive sample of PNs who completed the required program of education in order to provide cervical screening and well women’s health care services was recruited to the study. Data is presented in categories, however a limitation of the study is that a fully integrated grounded theory was unable to be produced due to sampling constraints.

Results

Four enablers for the implementation of a change in the PN role to include cervical screening and well women’s health checks are identified in this study. These enablers are: GPs being willing to relinquish the role of cervical screener and well women’s health service provider; PNs being willing to expand their role to include cervical screening and well women’s health services; clients preferring a female practice nurse to meet their cervical screening and well women’s health needs; and the presence of a culture that fosters interprofessional teamwork. Seven strategies for successfully implementing change from the perspective of PNs are also constructed from the data. This study additionally highlights the lack of feedback on smear quality provided to PNs cervical screeners and well women’s health service providers.

Conclusions

The influence of consumers on the landscape of primary care service delivery in Australia is of particular note in this study. Developing interprofessional teams that maximise each health care provider’s role will be fundamental to comprehensive service delivery in the future.