University Professors’ Perceptions About Patient Safety Teaching in an Interprofessional Education Experience: A Phenomenological Study

Background: Interprofessional education (IPE) and patient safety are recurrent and linked themes within the field of healthcare worldwide. International organizations have repeatedly called for and research has shown the benefits of health and social care professionals learning how to work collaboratively and efficiently to provide safer and better care. This study was undertaken to explore professors’ perceptions and experiences of an IPE curricula project with a view to improving future patient safety teaching in undergraduate health courses. Methods: This qualitative study utilized phenomenology as a theoretical framework. The participants were 11 professors from a public university in south-eastern Brazil, recruited through purposeful sampling. Data were collected through semi-structured interviews, which were transcribed and thematically analyzed. Findings: Four themes were identified: (a) sustaining IPE; (b) stakeholder involvement; (c) pedagogy; and (d) team learning. Enablers to patient safety teaching included the co-location of professors and sharing projects and lectures between them in consonance with the IPE project. Barriers included lack of knowledge of the patient safety national program, inadequate staffing, and significant academic workload. Conclusion: Professors revealed critical challenges to patient safety teaching within an IPE curriculum. They perceived patient safety to be an important topic for students but needed more support to integrate the topic into their routine as a formal activity. We call for patient safety policy to be more integrated within the educational system, with the active involvement of professors and other local stakeholders, and for its impact to be evaluated. Methods: This qualitative study utilized phenomenology as a theoretical framework. The participants were 11 professors from a public university in south-eastern Brazil, recruited through purposeful sampling. Data were collected through semi-structured interviews, which were transcribed and thematically analyzed. Findings: Four themes were identified: (a) sustaining IPE; (b) stakeholder involvement; (c) pedagogy; and (d) team learning. Enablers to patient safety teaching included the co-location of professors and sharing projects and lectures between them in consonance with the IPE project. Barriers included lack of knowledge of the patient safety national program, inadequate staffing, and significant academic workload. Conclusion: Professors revealed critical challenges to patient safety teaching within an IPE curriculum. They perceived patient safety to be an important topic for students but needed more support to integrate the topic into their routine as a formal activity. We call for patient safety policy to be more integrated within the educational system, with the active involvement of professors and other local stakeholders, and for its impact to be evaluated. Methods: This qualitative study utilized phenomenology as a theoretical framework. The participants were 11 professors from a public university in south-eastern Brazil, recruited through purposeful sampling. Data were collected through semi-structured interviews, which were transcribed and thematically analyzed. Findings: Four themes were identified: (a) Sustaining IPE; (b) Stakeholder involvement; (c) Pedagogy; and (d) Team learning. Enablers to patient safety teaching included the co-location of professors and sharing projects and lectures between them in consonance with the IPE project. Barriers included lack of knowledge of the patient safety national program, inadequate staffing, and significant academic workload. Conclusion: Professors revealed critical challenges to patient safety teaching within an IPE curriculum. They perceived patient safety to be an important topic for students but needed more support to integrate the topic into their routine as a formal activity. We call for patient safety policy to be more integrated within the educational system, with the active involvement of professors and other local stakeholders, and for its impact to be evaluated

Noise pollution in hospitals

This was a conference presentation I gave on my own at Acoustics 2019: Conference of the UK Institute of Acoustics. The paper, which will be published in conference proceedings, was based on an interdisciplinary project entitled HPNoSS, Hospital Project on Noise and Sleep in Hospitals. Although the presentation was entirely by me, the paper to be published was co-authored by Andreas Xyrichis and other members of the HPNoSS team (see separate item, BMJ article)

Intensive care discharge summaries for general practice staff: a focus group study

Understanding how patients and relatives can be supported after hospital discharge is a UK research priority. Intensive Care Unit (ICU) discharge summaries are a simple way of providing GPs with the information they require to coordinate ongoing care, but little evidence is available to guide best practice

Perspectives of Intensive Care patients and family members on competencies for Advanced Intensive Care nurses in Europe

BackgroundOne output from the International Nursing Advanced Competency-based Training for Intensive Care (INACTIC) collaboration is a set of core competencies for advanced practice Intensive Care Unit (ICU) nurses across Europe. Some European countries, such as the UK, have identified such competencies, however, these advanced practice roles are rarely practiced across the rest of Europe. The INACTIC competencies were developed with an expert panel of 184 ICU nurses from 20 countries. It is also important to examine what patients and relatives with experience of intensive care felt about these competencies. AimTo examine the views of recovered ICU patients and relatives regarding the INACTIC competencies.MethodsThree patient and relative focus groups were conducted in England (n=5), Scotland (n=4) and Greece (n=4) to discuss a lay version of the INACTIC competencies. Discussions were open ended, followed a topic guide, recorded and transcribed verbatim. Analysis followed a conventional thematic approach, with the findings discussed iteratively among the authors.ResultsThe feedback from across the focus groups resulted in three themes: 1) the importance of nurses being empowered to advocate for the patient; 2) the centrality of communication; and, 3) the impact of variability in ICU practices. There was a notable difference with the Greek focus group; because of restricted family visiting policies, relatives did not feel encouraged to participate in patient care.ConclusionsThe perspectives of patients and relatives largely aligned with the consensus of the INACTIC expert panel. Local differences in ICU experience highlight the changes that some ICUs would need to make for the INACTIC competencies to be embedded

Doing interprofessional research in the COVID-19 era : a discussion paper

The COVID-19 pandemic, and ensuing physical distancing measures, poses challenges for researchers in the field of interprofessional care. Pandemic management has highlighted the centrality of interprofessional working to effective healthcare delivery during crises. It is essential to find ways to maintain interprofessional research that has commenced, while also designing research to capture important learning from pandemic management and response. However, it also creates opportunities for new research projects and novel research designs. This discussion paper explores ways of adapting existing research methodologies and outlines potential avenues for new research. Specifically, considerations to bear in mind when designing interprofessional research during the pandemic include research ethics and integrity, research design, data collection methods, research opportunities, implications and limitations. Interprofessional research can continue to make a valuable contribution in informing global responses to COVID-19 and in planning for future global health crises. We call for, insofar as possible, for interprofessional research to continue to be developed during this time.PostprintPeer reviewe

Virtual visiting in intensive care during the COVID-19 pandemic: a qualitative descriptive study with ICU clinicians and non-ICU family team liaison members

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/Objective: To understand the experiences and perceived benefits of virtual visiting from the perspectives of intensive care unit (ICU)-experienced clinicians and non-ICU-experienced family liaison team members. Design: Qualitative descriptive study. Setting: Adult intensive care setting across 14 hospitals within the UK National Health Service. Participants: ICU-experienced clinicians and non-ICU-experienced family liaison team members deployed during the first wave of the COVID-19 pandemic. Methods: Semistructured telephone/video interviews were conducted with ICU clinicians. Analytical themes were developed inductively following a standard thematic approach, using ‘family-centred care’ and ‘sensemaking’ as sensitising concepts. Results: We completed 36 interviews, with 17 ICU-experienced clinicians and 19 non-ICU-experienced family liaison team members. In the context of inperson visiting restrictions, virtual visiting offered an alternative conduit to (1) restoring the family unit, (2) facilitating family involvement, and (3) enabling sensemaking for the family. Virtual visits with multiple family members concurrently and with those living in distant geographical locations restored a sense of family unit. Family involvement in rehabilitation, communication and orientation activities, as well as presence at the end of life, highlighted how virtual visiting could contribute to family-centred care. Virtual visits were emotionally challenging for many family members, but also cathartic in helping make sense of their own emotions and experience by visualising their relatives in the ICU. Being able to see and interact with loved ones and their immediate care providers afforded important cues to enable family sensemaking of the ICU experience. Conclusions: In this UK qualitative study of clinicians using virtual ICU visiting, in the absence of inperson visiting, virtual visiting was perceived positively as an alternative that promoted family-centred care through virtual presence. We anticipate the perceived benefits of virtual visiting may extend to non-pandemic conditions through improved equity and timeliness of family access to the ICU by offering an alternative option alongside inperson visiting.Peer reviewedFinal Published versio

Interventions to promote patients and families' involvement in adult intensive care settings: a protocol for a mixed-method systematic review.

BACKGROUND: There has been an identified need for greater patient and family member involvement in healthcare. This is particularly relevant in an intensive care unit (ICU), as the family provides a key communicative and practical link between patient and clinician. Family members have been deemed a positive beneficial influence on ICU care and recovery processes, yet they themselves are often emotionally affected after discharge. There has been no standardised evidenced-based approach which explores research on family member involvement and the range and quality of contributions remain unclear. This project will undertake a systematic review to assess the evidence base for interventions designed to promote patient and family member involvement in adult intensive care settings and develop a comprehensive typology of interventions for use by clinicians, patients and carers. METHODS: The following databases will be searched without date restriction: MEDLINE, EMBASE and CINAHL, as well as the Cochrane Central Register of Controlled Trials, Joanna Briggs and Cochrane Libraries. Manual searches of recent back issues of leading ICU and patient experience journals will also be undertaken, as will the reference lists of included studies. Unpublished literature will be sought through grey literature databases, including GreyLit and OpenGrey. All evaluation studies that consider intervention activities to promote patient and family member involvement in adult ICUs will be included; all research designs will be eligible. We will seek to include studies that report on a mixture of relevant outcomes for patients and family members. Abstracts and papers will be independently screened by at least two members of the team to determine their inclusion. Included papers will be assessed for methodological rigour using a standard rating approach, which assesses 'quality of study' and 'quality of information'. Quality assessment will be completed by at least two members of the team. Data on interventions, evaluation methods and outcomes will be collated using a predetermined extraction table. These are likely to be heterogeneous in nature, which will mean that the review will follow a narrative approach to synthesis. DISCUSSION: The review will provide valuable and rigorous insight into the range and quality of interventions available to promote patient and family member involvement in ICU. This is the first step towards addressing the absence of a synthesis of research for this context, and will, in addition, develop a typology of available interventions that will help service users and clinicians make informed decisions about the approaches to patient and family member involvement which they might want to adopt. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42018086325)

Resilient healthcare theory as a lens to research emergency department operations: a protocol for a scoping review

Introduction Emergency departments (EDs) are complex systems that have constant fluctuations in demand, creating mismatches with planned capacity. Despite the complexity of ED operations, quality and safety improvement are often approached in a reactive, linear and reductionist manner. There is increasing interest in adopting Resilient Healthcare (RHC) techniques based on complex systems thinking as a method for quality improvement and research in EDs. However, the evidence for this approach is still developing and it is not clear what techniques have been used so far and which are most effective. This scoping review will be conducted between March 2022 until May 2022. It seeks to examine the international literature for available reports that have adopted RHC theory to study ED operations and identify approaches used and proposed benefits. Methods and analysis The methodology for scoping reviews outlined by Arksey and O’Malley (2005) will be followed, acknowledging refinements made to the scoping review process by Levac et al (2010). The methodology consists of five steps: (1) identifying the research question; (2) identifying the relevant literature; (3) study selection; (4) charting the data; and (5) collating, summarising and reporting the results. A two-stage approach will be undertaken to synthesise and report results: (1) numerical analysis of the nature and distribution of studies (the overall number of studies, country of origin, the most studied core function of ED, type of research design); and (2) a thematic mapping of the literature. Ethics and dissemination Scoping review methodology synthesises published data and, therefore, does not require ethical approval. An article formatted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses forScoping Reviews reporting guidance will be submitted for publication to a scientific journal. Findings will also be presented at relevant advanced practice conferences and disseminated within clinical and academic groups