The identification of components for a structured reflective tool to enhance continuous professional development of accident and emergency practitioners

Continuous professional development has become an essential part of contemporary nursing practice. Continuous professional development implies that accident and emergency (A&E) practitioners can never stop learning. A&E practitioners therefore must be prepared to seek new challenges and reflect honestly upon their performance and experiences and adjust their practice in order to obtain and maintain quality service delivery. Network sampling was done and a focus group was used to collect data. This study sought to identify components for a structured reflective tool to enhance continuous professional development of A&E practitioners. Reflection was seen as an important learning strategy and components for a structured reflective tool to enhance continuous professional development of A&E practitioners were identified. In addition essential elements that should be in place prior to the implementation of reflection into clinical practice were identified. CopyrightDissertation (MCur)--University of Pretoria, 2009.Nursing Scienceunrestricte

Requirements for reflection in the critical care environment

BACKGROUND : Reflection is recognised as an important method for practice development. The importance of reflection is well documented in the literature, but the requirements for reflection remain unclear. OBJECTIVES : To explore and describe the requirements for reflection in the critical care environment as viewed by educators of qualified critical care nurses. METHOD : A focus group interview was conducted to explore and describe the views of educators of qualified critical care nurses regarding requirements for reflection in the critical care environment. RESULTS : The themes that emerged from the focus group were buy-in from stakeholders – management, facilitators and critical care nurses, and the need to create an environment where reflection can occur. CONCLUSION : Critical care nurses should be allowed time to reflect on their practice and be supported by peers as well as a facilitator in a non-intimidating way to promote emancipatory practice development.http://www.curationis.org.za/am201

Important factors for planning nurse staffing in the emergency department : a consensus study

INTRODUCTION : Planning adequate nurse staffing in the emergency department (ED) is challenging. Although there are models to determine nurse staffing in EDs, these models do not consider all the factors. Inadequate nurse staffing causes overcrowding, poor quality of patient care, increased hospital costs, poor patient outcomes and high levels of burnout amongst nurses. In this paper, we report stakeholders’ perceptions of important factors to be considered when planning ED nursing ratios. METHODS : We applied a consensus research design. The data was generated from modified nominal group techniques followed by an e-Delphi with two rounds. The factors were generated during two nominal groups by 19 stakeholders which included management and healthcare professionals working in EDs. The generated factors were then put on a survey format for use in an e-Delphi. Using purposive and snowball sampling the survey was distributed to 74 national and international experts for consensus. RESULTS : Ultimately, 43 experts agreed (a validity index of ≥ 80%) on four categories namely: hospital, staff, patient and additional categories which included 17 related factors. CONCLUSION : Ideal nurse staffing ratios are influenced by the complexity of the environment and interactions between multiple factors. The categories and factors identified emphasised the need for extensive further research to ensure a financially viable model that will be accepted by both staff and patient, and thus promote optimal outcomes.http://www.elsevier.com/locate/aaen2022-03-09hj2021Nursing Scienc

Healthcare professionals and pregnant and post-natal women's perceptions of interprofessional collaboration in a maternity care facility : a qualitative study from Botswana

OBJECTIVE : To explore the perceptions of healthcare professionals and pregnant and post-natal women regarding interprofessional collaboration in a maternity care setting in Botswana, a low-to-middle-income country in Sub-Sahara Africa. DESIGN : A descriptive qualitative design using in-depth interviews with forty participants, including healthcare professionals and women in maternity wards. Data were transcribed and thematically analysed. SETTING : Antenatal, delivery and post-natal maternity wards in a referral hospital that provides basic and specialist care in Botswana. PARTICIPANTS : We interviewed 13 pregnant and post-natal women and 27 healthcare professionals in the maternity care wards. FINDINGS : Participants perceived several interrelated factors that influenced the delivery of interprofessional collaborative care. Interpersonal factors such as poor communication, disrespectful behaviours and inadequate teamwork practices prevented interprofessional collaboration. Other barriers to collaboration included lack of understanding of each other's roles and responsibilities, ineffective coordination of resources, hierarchical power struggles and poor collaborative leadership. KEY CONCLUSIONS : Effective interprofessional collaboration remains elusive in this maternity care setting. Healthcare systems in low-to-middle-income countries may benefit from interventions for healthcare professionals to learn and practice interprofessional collaborative care.Botswana Open University, Gaborone, Botswana.https://www.elsevier.com/locate/midw2024-07-17hj2024Nursing ScienceNon

Voices of rape victims managed in an emergency department

Someone is raped every 35 seconds in South Africa. Rape victims seek healthcare from various facilities, including emergency departments. The management of rape victims is guideline driven and the way in which these victims perceive their initial management is not always taken into consideration. For healthcare providers to develop their practice, the voice of adult rape victims should be incorporated. Individual interviews were conducted with 10 participants in order to gain a deeper understanding of the rape victims’ views of their initial management received in the emergency department. Content analysis was used to analyse the data. The participants voiced feelings such as; being left alone, the need for themselves to be involved during the management and the variant competencies of healthcare providers. These voiced views of the rape survivors should be incorporated in a practice development initiative to move current workplace culture in emergency departments towards a patient-centred culture.http://www.ajol.info/journal_index.php?jid=153&ab=ajpherd2016-10-31hb201

Documentation of wounds in emergency departments through a forensic lens

BACKGROUND : Nurses document wounds to direct and evaluate the care. People admitted to emergency departments with wounds should be regarded as potential forensic patients, requiring meticulous documentation for evidence purposes. AIM : To explore the documentation of wounds in emergency departments through a forensic lens and compare it between different levels of emergency departments. METHODS : In this descriptive retrospective study, we randomly sampled 515 paper-based medical files of patients who sustained wounds admitted to three selected emergency departments. The files were analysed using a structured data collection tool the data were descriptively analysed. RESULTS : All files included information on the type of wound (100%) and the site of the wound (100%) with most files including the mechanisms of injury (98.6%). Few files included information on blood loss (18.1%) and the size of the wound (15%). Only one file included information on the contents of the wound. No files included information on the wound's shape and the surrounding skin's condition. CONCLUSION : Wounds were poorly documented in emergency departments, irrespective of the level of care. Nurses in emergency departments should have strict guidelines for documenting wounds since accurate documentation protects patients’ human rights and protects nurses.https://www.elsevier.com/locate/aaenhj2024Nursing ScienceStatisticsSDG-03:Good heatlh and well-bein

Forensic patients in the emergency department : who are they and how should we care for them?

BACKGROUND : Patients who suffer violent, crime related injuries are likely to seek medical assistance in emergency departments. Forensic patients may not disclose the cause of their injuries leading to the impairment of evidence. We explored healthcare providers’ perceptions of forensic patients and how they should be cared for. METHOD : The perceptions of physicians and nurses regarding the profiles and care of forensic patients were explored in three urban emergency departments. The data were collected through a talking wall and analysed collaboratively, with the participants, using content analysis. RESULTS : Healthcare providers in emergency departments differentiated between living and deceased forensic patients. Healthcare providers identified living forensic patients as victims of sexual assault, assault, gunshots and stab wounds, and abused children. Deceased patients included patients that were dead on arrival or died in the emergency departments. Healthcare providers acknowledged that evidence should be collected, preserved and documented. CONCLUSION : Every trauma patient in the emergency department should be treated as a forensic patient until otherwise proven. If healthcare providers are unable to identify forensic patients and collect the evidence present, the patients’ human right to justice will be violated.University-based Nursing Education of South Africa (UNEDSA), funded by the ELMA foundation of South Africa, the Vice-Chancellor’s Grant (University of Pretoria) and the National Research Fund (Vulnerable Discipline Developing Health Science Research Grant).http://www.elsevier.com/locate/aaen2019-09-01hj2017Nursing Scienc

Considerations for promoting the implementation of work-based interprofessional education programmes : a scoping review

BACKGROUND : Effective inter-professional collaboration may improve healthcare outcomes, including maternal and child healthcare settings where unfavourable outcomes are often due to communication and collaboration failures. OBJECTIVE : Explore the considerations for promoting the implementation of work-based interprofessional education programmes. METHODS : A scoping review guided by the methodological framework of Arksery and O'Malley was used to analyse 28 articles published between 2000 and 2020. The reporting was guided by the PRISMA extension for Scoping Reviews. RESULTS : Twenty-seven of 28 articles were studies conducted in high-income countries. The review revealed considerations which were themed as 1) mobilisation of resources, 2) helpful learning environment, 3) healthcare professional's valuation and 4) barriers prior to implementing IPE/IPC. Successful implementation of interventions triggered motivation, confidence, self-efficacy, value for IPE/IPC. CONCLUSION : Our findings demonstrate that there are specific considerations that can contribute to the uptake of IPE/IPC interventions in the clinical setting.The Botswana Open University.http://www.elsevier.com/nedthj2024Nursing ScienceSDG-04:Quality Educatio

A concept analysis of person-centred handover practices : the meaning in emergency departments

BACKGROUND : Transfer of patients from the prehospital to the in-hospital environment is a frequent occurrence requiring a handover process. Habitually, emergency care practitioners and healthcare professionals focus on patient care activities, not prioritising person-centred handover practices and not initiating person-centred care. AIM : The aim of this concept analysis was to define the concept person centred handover practices. METHODS : The eight steps for Walker and Avant’s method of concept analysis. RESULTS : Thirty-one articles were included for final review including qualitative and quantitative studies, literature reviews and audits. This concept analysis guided the development of an concept definition of person-centred handover practices between emergency care practitioners and healthcare professionals in the emergency department as person- centred handover practices are those handovers being performed while including all identified defining attributes such as structure, verbal, and written information transfer, interprofessional process, inclusion of the patient and/ or family, occurs at the bedside, without interruption. CONCLUSIONS : Results suggested that person-centred handover practices involve verbal and non– verbal interprofessional communication within a specific location in the emergency department. It requires mutual respect from all professionals involved, experience and training, and the participation of the patient and / or family to improve patient outcomes and quality patient care. A definition for the concept may encourage the implementation of person-centred handover practices in emergency departments.https://www.elsevier.com/locate/aaenhj2024Nursing ScienceSDG-03:Good heatlh and well-bein

Reaching consensus on the definition of person-centred handover practices in emergency departments : a modified online Delphi

DATA AVAILABILITY STATEMENT : The data that support the findings of this study are openly available in University of Pretoria Research data at https://figshare.com/s/0923702aa9b0aa7fd1d5, reference number 10.25403/UPresearchdata.24310696.AIM : To reach consensus on the definition and attributes of ‘person-centred handover practices’ in emergency departments. BACKGROUND : Handover practices between emergency care practitioners and healthcare professionals in emergency departments are important and should be conducted meticulously. Person-centred handover practices may enhance the delivery of person-centred care in emergency departments. DESIGN : A three-round online Delphi survey. METHODS : Nine experts participated in a three round Delphi survey. The expert panel comprised experts from nine countries. Quantitative data were descriptively analysed, and qualitative data were thematically analysed. A consensus of 80% had to be reached before an attribute and definition could be accepted. RESULTS : Experts reached a consensus of 79% in round one, 95% in round two and 95% in round three. A final set of six attributes were agreed upon and the final concept definition was formulated. CONCLUSION : Person-centred handover practices have not been implemented in emergency departments. Yet, person-centred handover practices may enhance the delivery of person-centred care, which has multiple benefits for patients and healthcare practitioners. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE : Person-centred care is not generally implemented in emergency departments. Person-centred handover practices can lead to person-centred care. Handover practices in emergency departments are a high-risk activity. Despite numerous calls to standardise and improve handover practices, they remain a problem. Developing a standardised definition could be a first step towards implementing person-centred handover practices in emergency departments. REPORTING METHOD : The study adhered to the relevant EQUATOR reporting guidelines: Guidance on Conducting and Reporting Delphi Studies (CREDES) checklist. IMPACT (ADDRESSING) : Improve handover practices and patient care. Improve person-centred care in emergency departments. PATIENT OR PUBLIC CONTRIBUTION : Emergency care practitioners and nurses experienced in handover practices and/or person-centred care, working in clinical and academic fields, participated in the study by sharing their expert knowledge during each of the Delphi rounds.http://www.wileyonlinelibrary.com/journal/jocnhj2024Nursing ScienceSDG-03:Good heatlh and well-bein