Getting Patients Involved in Care Redesign: What the Research Says

By Sylvia Foley, AJN senior editor

“I think the whole thing is we’re trying to im­prove care. It’s all about [patients] anyways. So if we’re gonna make changes that impact them I think we have to get them involved.” —study participant

Although there is considerable support for increasing patient involvement in health care, it’s not clear how best to achieve this. And few researchers have specifically investigated the views of patients and providers on patient engagement. In this month’s CE–Original Research feature, “The Perceptions of Health Care Team Members About Engaging Patients in Care Redesign,” Melanie Lavoie-Tremblay and colleagues describe findings from their recent study. Here’s a brief overview.

Objective: This study sought to explore the perceptions of health care workers about engaging patients as partners on care redesign teams under a program called Transforming Care at the Bedside (TCAB), and to examine the facilitating factors, barriers, and effects of such engagement.
Design: This descriptive, qualitative study collected data through focus groups and individual interviews. Participants included health care providers and managers from five units at three hospitals in a university-affiliated health care center in Canada.
Methods: A total of nine focus groups and 13 individual interviews were conducted in April 2012, 18 months after the TCAB program began in September 2010. Content analysis was used to analyze the quali­tative data.
Findings: Health care providers and managers benefited from engaging patients in the decision-making process because the patients brought a new point of view. Involving the patients exposed team members to valuable information that they […]

2017-07-27T14:45:30-04:00July 16th, 2014|nursing perspective, nursing research|1 Comment

Nursing Is Hazardous to Our Health

By Shawn Kennedy, AJN interim editor-in-chief

We all know that our nursing jobs expose us to various hazards—back and joint problems, needlesticks and other means of exposure to infectious diseases, traumatic injuries from encounters with violent patients or their family members, just to name some common ones. And as if that’s not enough, the psychological toll taken can result in burnout and even PTSD, which wreak havoc on retention. Heart disease and depression should probably also be on the list.

You may have seen news reports about a study with Danish nurses, published in the May issue of Occupational and Environmental Medicine. The researchers found that nurses younger than 51 years at baseline who perceived their workplaces as highly stressful were significantly more likely to have ischemic heart disease during the 15-year follow-up. Now, as the Journal of Clinical Psychiatry reports, a Finnish study has found that nurses and physicians who work in overcrowded acute care units have “twice the risk of sickness absence due to depressive disorders” compared with colleagues working in less crowded areas. And Health Policy reports on a study revealing that, among Canadian nurses, “Depression is a significant determinant of absenteeism for both RNs and LPNs.”

Is anyone surprised? Not nurses, for sure, and probably no one who’s worked at or been a patient in a hospital recently. With few exceptions, hospitals are generally terrible places to work. Yes, the

TCAB: What’s Your Hospital Doing to Improve Care?

By Diana J. Mason, PhD, RN, AJN Editor-in-Chief Emeritus

November 2009 report cover

What makes a “good hospital”? A patient might have the best surgeon in the world; but as any nurse will tell you, that patient will die unless the surgeon has a top-notch nursing staff to ensure that the patient is well prepared for the surgery and well supported during the recovery period. Too many hospitals have lost their understanding of what’s essential to ensure great clinical and financial outcomes.  In such hospitals, nurses aren’t included in decision making, have little local authority, are penalized for identifying factors that lead to poor care, and can’t claim excellent team relationships.

The American Nurses Credentialing Center’s Magnet Recognition Program has helped to identify the factors that lead to excellence in nursing care, granting Magnet status to hospitals that provide such excellence. Now an initiative known as Transforming Care at the Bedside (TCAB) has provided the framework and tools for empowering bedside nurses to become  agents for change. TCAB nurses work with other health care team members to improve care processes and effectiveness, focusing on four areas:  the safety and reliability of care, teamwork and job satisfaction, patient and family satisfaction, and “value-added care.” (Increasing the amount of […]

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