Patient participation in nursing bedside handover: a systematic mixed-methods review

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; (1) patient-centred handover and (2) nurse-centred handover. Segregated synthesis of research of nurses’ perceptions included three categories: (1) viewing the patient as an information resource; (2) dealing with confidential and sensitive information; and (3) enabling patient participation. The segregated synthesis of QI projects included two categories: (1) nurse barrier to enacting patient participation in bedside handover; and (2) involving patients in beside handover. Once segregated findings were configured, we discovered that the patients’ role in bedside handover involves contributing clinical information related to their care or progress, which may affect patient safety. Barriers relate 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 ensure patients’ viewpoint is captured. Many barriers and strategies identified QI projects were from the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure improved quality of QI projects

Counting the countless – rape victimisation during the Rwandan Genocide

Rape is regularly committed during a period of collective violence such as war. The article discusses the Rwandan genocide during which rape was used with the deliberate intent to destroy in whole or in part the Tutsi community. Rape is not often studied in such particular contexts, so little is known about its prevalence in genocide; as a consequence, the comprehensive impact of genocidal incidents remains underaddressed. We estimate the prevalence of rape victimization (i.e., the number of women raped) during the Rwandan genocide in 1994. In doing so, we apply a methodology in which we use conservative victimization estimates, disaggregating between victims who were killed and victims who survived. We arrive at an estimated lower bound of a little more than 350,000 female rape victims, most of whom were Tutsi. We discuss the importance of arriving at reliable estimates, the methodology, and implications for future research. © 2009 Georgia State University Research Foundation, Inc

The Selection of Situations by the ICC - An Empirically Based Evaluation of the OTP's Performance

The main aim of the International Criminal Court (ICC) is to prosecute the most serious crimes of concern to the international community. One of the most valued features of the ICC is the independent position of the Prosecutor in selecting situations and cases to investigate. The Prosecutor, however, has been heavily criticized for his selection policy and countries from the African Union even threatened to withdraw from the ICC because of its alleged bias and unfair focus on African political leaders. In this article we present the results of our explorative study in which we empirically evaluate the situations selection policy of the ICC Prosecutor. We conclude that given the ICC's limited jurisdictional reach, the Prosecutor is generally focusing on the gravest situations where international crimes are supposedly committed. copy; 2015 by Koninklijke Brill NV, Leiden, The Netherlands