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British Journal of Clinical Pharmacology Apr 2017The aim of the present study was to determine the barriers and motives influencing consumer reporting of adverse drug reactions (ADRs). (Review)
Review
AIM
The aim of the present study was to determine the barriers and motives influencing consumer reporting of adverse drug reactions (ADRs).
METHODS
A systematic review, guided by the Cochrane Handbook, was conducted. Electronic searches included MEDLINE, EMBASE, PsycINFO, CINAHL, PubMed and the Cochrane Database of Systematic Reviews from 1964 to December 2014. Eligible studies addressed patients' perceptions and factors influencing ADR reporting. Studies about healthcare professional (HCP) reporting of ADRs were excluded. Studies were appraised for quality, and results were analysed descriptively.
RESULTS
Of 1435 citations identified, 21 studies were eligible. Studies were primarily conducted in the UK, the Netherlands and Australia. The identified barriers to patient reporting of ADRs (n = 15 studies) included poor awareness, confusion about who should report the ADR, difficulties with reporting procedures, lack of feedback on submitted reports, mailing costs, ADRs resolved and prior negative reporting experiences. The identified motives for patients reporting ADRs (n = 10 studies) were: preventing others from having similar ADRs, wanting personal feedback, improving medication safety, informing regulatory agencies, improving HCP practices, responding to HCPs not reporting their ADRs and having been asked to report ADRs by HCPs.
CONCLUSIONS
Most patients were not aware of reporting systems and others were confused about reporting. Patients were mainly motivated to make their ADRs known to prevent similar suffering in other patients. By increasing patient familiarity and providing clear reporting processes, reporting systems could better achieve patient reporting of ADRs.
Topics: Adverse Drug Reaction Reporting Systems; Drug-Related Side Effects and Adverse Reactions; Feedback; Health Knowledge, Attitudes, Practice; Humans; Motivation; Patients; Self Report
PubMed: 27868226
DOI: 10.1111/bcp.13159 -
The Patient Apr 2017Soft tissue sarcomas (STS) are a heterogenous group of rare tumors that involve the connective tissue in the body (e.g. muscle, tendons). As with many rare tumors,... (Review)
Review
BACKGROUND
Soft tissue sarcomas (STS) are a heterogenous group of rare tumors that involve the connective tissue in the body (e.g. muscle, tendons). As with many rare tumors, little is known about the impact of STS on patient well-being.
OBJECTIVE
The aim of this review was to better understand current knowledge related to patient experience and quality of life (QOL) following diagnosis of STS.
METHODS
A systematic review of English-language articles published from 2005 to 2015 was conducted in the PubMed/MEDLINE, Embase, PsychINFO, and Evidence-Based Medicine databases. The review included recent conference proceedings and advocacy websites. Articles were eligible if they included adult STS patient-reported outcomes (PROs) or details on patient experience.
RESULTS
Overall, 3430 articles were identified and 20 were eligible for inclusion. Of these, 14 were clinical studies that included PRO measures, 1 summarized PRO measures used in STS studies, and 5 described the STS patient experience. Patients with STS report a range of impacts on QOL, including emotional well-being, body image, functional deficit following surgery, and practical considerations such as child care and work.
CONCLUSIONS
Few studies have published either qualitative or quantitative data on the patient experience with STS. While STS has a measurable impact on QOL, there is a lack of detailed information in the published literature. Although PROs are used in clinical studies of STS, they are not STS-specific and may not capture the unique needs of this population. There is a need for qualitative research to better understand both patient and caregiver experiences in STS.
Topics: Adult; Aged; Aged, 80 and over; Caregivers; Evidence-Based Medicine; Female; Humans; Male; Middle Aged; Patient Satisfaction; Patients; Qualitative Research; Quality of Life; Sarcoma
PubMed: 27744499
DOI: 10.1007/s40271-016-0200-1 -
Journal of Clinical Nursing May 2023To review the current literature to map and explore the interventions that have been considered or used by nurses to support adult patients' self-management during... (Review)
Review
AIMS AND OBJECTIVES
To review the current literature to map and explore the interventions that have been considered or used by nurses to support adult patients' self-management during hospitalisation.
BACKGROUND
Nurses can play an important role in supporting patients' self-management. Currently, however, it is unclear how nurses perform this task during a patient's stay in hospital. Traditionally, nurses take the primary role in managing patients' care during hospitalisation. Ideally, patients should have the opportunity to continue applying strategies to manage their health conditions as much as possible while in the hospital. This can increase patients' self-efficacy and decrease unnecessary readmissions.
DESIGN
Scoping review informed by the Joanna Briggs Institute methodology.
METHODS
A database search was undertaken using Pubmed, CINAHL, PsycInfo, Cochrane, Embase and grey literature sources. Data from the included studies were mapped and summarised in a narrative summary. To synthesise the information that was given about each intervention, we conducted a qualitative inductive content analysis. Results are reported in accordance with the guidelines for reporting Items for systematic review and meta-analyses extension for scoping review (PRISMA-ScR) (Supplementary File 1).
RESULTS
83 documents were included in this review. Based on the information about the interventions, three themes were identified: 'self-management support activities', 'focus of self-management support' and the 'intervention procedure'. Five self-management support activities can be distinguished: 'giving education', 'counselling and coaching', 'enhancing responsibility', 'engaging family-caregivers' and 'supporting transition from hospital to home'. The interventions focused on improving disease-related knowledge and on strengthening several self-management skills. Information about the procedure, development and the theoretical underpinning of the intervention was often limited.
CONCLUSIONS
Most activities within the nursing interventions to support adult patients' self-management during hospitalisation are the part of regular nursing care. However, the transfer of responsibility for care task to the patient is relatively new. Further research could focus on developing interventions addressing all aspects of self-management and that are embedded in the patient's care pathway across settings.
RELEVANCE TO CLINICAL PRACTICE
Clinical nurses may improve nursing care by supporting all aspects of patients' self-management and facilitate patients as much as possible for taking responsibility for self-management tasks during hospitalisation.
Topics: Adult; Humans; Self-Management; Clinical Competence; Patients; Hospitals; Nurses
PubMed: 35118738
DOI: 10.1111/jocn.16242 -
Journal of Healthcare Management /... 2017Because Medicare reimbursements are now, in part, based on patient satisfaction scores, hospitals are increasingly concerned about improving patient satisfaction.... (Review)
Review
Because Medicare reimbursements are now, in part, based on patient satisfaction scores, hospitals are increasingly concerned about improving patient satisfaction. However, little is known about the different characteristics that are associated with higher patient satisfaction. This study was conducted to systematically review the patient satisfaction literature and to identify predictors of patient satisfaction based on measures from the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey. We searched the PubMed and Scopus databases from January 2007 to February 2015 for relevant peer-reviewed studies. A total of 41 studies met our inclusion criteria and were categorized into three groups (levels) based on the types of predictors used in the study: patient (12 articles, 29.9%), hospital (29 articles, 70.1%), or market (4 articles, 9.7%) predictors. We present a narrative review of the included studies in which certain patient- and hospital-level predictors were consistently associated with higher patient satisfaction (e.g., patient perception of well-managed pain and not-for-profit status) or lower patient satisfaction (e.g., racial/ethnic minority, hospital's safety net status, metropolitan area). Moreover, several predictors had mixed relationships with patient satisfaction across studies (e.g., teaching status, number of beds). Finally, we found that only a small number of studies have examined the association between market-level predictors and patient satisfaction.
Topics: Health Care Surveys; Hospitals; Humans; Inpatients; Patient Satisfaction; Surveys and Questionnaires
PubMed: 28683051
DOI: 10.1097/JHM-D-15-00050 -
Journal of Shoulder and Elbow Surgery Aug 2021Amid rising health care costs and recent advances in surgical and anesthetic protocols, the rate of outpatient joint arthroplasty has risen steadily in recent years.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Amid rising health care costs and recent advances in surgical and anesthetic protocols, the rate of outpatient joint arthroplasty has risen steadily in recent years. Although the safety of outpatient total knee arthroplasty and total hip arthroplasty has been well established, outpatient shoulder arthroplasty is still in its infancy. The purpose of this study was to synthesize the current literature and provide further data regarding the outcomes and safety of outpatient shoulder arthroplasty.
METHODS
A systematic review was conducted following the standard PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included were studies that evaluated the outcomes of patients undergoing outpatient total shoulder arthroplasty (TSA) or reverse TSA. Meta-analysis was conducted using Mantel-Haenszel statistics to generate odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) comparing outpatient and inpatient shoulder arthroplasty.
RESULTS
Twelve studies were included, with a total of 194,513 patients, of whom 7162 were outpatients. Of the studies, 8 were level III and 4 were level IV. The average age of the outpatients was 66.6 years, and the average age of the inpatients was 70.1 years. The overall OR for complications was significantly lower in outpatients (OR, 0.40; 95% CI, 0.35-0.45) than in inpatients. There was no significant difference in rates of 90-day readmission (OR, 0.88; 95% CI, 0.75-1.03), revision (OR, 0.96; 95% CI, 0.65-1.41), and infection (OR, 0.93; 95% CI, 0.64-1.35) when comparing outpatients with inpatients.
CONCLUSION
Outpatient TSA, in an appropriately selected patient population, is safe and results in comparable patient outcomes to those of inpatient shoulder arthroplasty. Given the expected increase in the number of patients requiring TSA, surgeons, hospital administrators, and insurance carriers should strongly consider the merits of a cost- and care-efficient approach to total shoulder replacement.
Topics: Aged; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Shoulder; Humans; Inpatients; Outpatients; Postoperative Complications; Retrospective Studies
PubMed: 33675972
DOI: 10.1016/j.jse.2021.02.007 -
Ciencia & Saude Coletiva May 2022Patient safety in health care is the cornerstone of quality in nursing care. It is a duty of nurses and an objective of the health organizations. This article aims to...
Patient safety in health care is the cornerstone of quality in nursing care. It is a duty of nurses and an objective of the health organizations. This article aims to analyze the scientific evidence on the nurses' perception and opinion on patient safety in the emergency department. Systematic literature review with 3 steps. 1) Primary search at CINHAL and MEDLINE. 2) A broader search, using the same keywords and search terms in the remaining database of the EBSCOHost platform. 3) Search the bibliographic references of the selected articles. The selected studies were published between 2014 and 2019. Five articles were selected. The nurses' perception reveal that the work environment, teamwork and matters related to the leadership of hierarchical superiors are fundamental factors to improve the quality of care provided and patient safety. Promoting teamwork improves patient care, reduces adverse events and improves quality. Recognizing the nurses' perception on patient safety culture in emergency services, contributes to improving the quality of care provided.
Topics: Emergency Service, Hospital; Hospitals; Humans; Inpatients; Patient Safety; Workplace
PubMed: 35544810
DOI: 10.1590/1413-81232022275.22742021 -
European Journal of Clinical... Jan 2018Drug-drug interactions (DDIs) are often avoidable and, if undetected, can lead to patient harm. This review aimed to determine the prevalence of potential DDIs (pDDIs),... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Drug-drug interactions (DDIs) are often avoidable and, if undetected, can lead to patient harm. This review aimed to determine the prevalence of potential DDIs (pDDIs), clinically relevant DDIs (DDIs that could lead to measurable patient harm, taking into account the patient's individual clinical profile) and DDIs that resulted in actual patient harm during hospitalisation.
METHOD
Four databases were scanned for English papers published from 2000 to 2016. Papers that reported prevalence of DDIs in the outpatient setting, at admission or discharge, involving only specific drugs, or in specific disease populations or age groups were excluded.
RESULTS
Twenty-seven papers met the inclusion criteria and were graded for quality using the Critical Appraisal Skills Programme (CASP) cohort study checklist. Ten papers were rated as 'poor', 14 as 'fair' and only three papers as 'good'. Overall, the meta-analysis revealed that 33% of general patients and 67% of intensive care patients experienced a pDDI during their hospital stay. It was not possible to determine the prevalence of clinically relevant DDIs or DDIs that resulted in actual patient harm as data on these categories were limited. Of the very few studies that reported on harm, only a small proportion of DDIs were found to have resulted in actual patient harm.
CONCLUSIONS
Standardisation of DDI definitions and research methods are required to allow meaningful prevalence rates to be obtained and compared. Studies that go further than measuring pDDIs are critically needed to determine the impact of DDIs on patient safety.
Topics: Drug Interactions; Drug-Related Side Effects and Adverse Reactions; Hospitalization; Humans; Inpatients; Medication Errors; Patient Safety; Prevalence
PubMed: 29058038
DOI: 10.1007/s00228-017-2357-5 -
Journal of Advanced Nursing Jan 2020To obtain a comprehensive insight of the impact of patient and family engagement on patient safety and identify issues in implementing this approach.
AIMS
To obtain a comprehensive insight of the impact of patient and family engagement on patient safety and identify issues in implementing this approach.
BACKGROUND
Patient and family engagement is increasingly emerging as a potential approach for improving patient safety.
DESIGN
Mixed method multilevel synthesis.
DATA SOURCES
PubMed, CINAHL, Embase, and Cochrance Library (January 2009-April 2018).
REVIEW METHODS
The review was conducted according to the principles recommended by the Cochrane Handbook for Systematic Review and in accordance with the PRISMA guidelines.
RESULTS
Forty-two relevant studies were identified. Common intervention groups included 'direct care' and 'organization' levels with 'consultation' and 'involvement' approaches, while the 'health system' level and 'partnership and shared leadership' approaches were rarely implemented. Findings revealed positive effects of the interventions on patient safety. Most study participants expressed their willingness to engage in or support patient and family engagement. However, existing gaps and barriers in implementing patient and family engagement were identified.
CONCLUSION
Future research should further focus on issuing consensus guidelines for implementing patient and family engagement in patient safety, extending the research scope for all aspects of patient and family engagement and patient safety and identifying priority areas for action that is suitable for each health facility.
IMPACT
Policymakers should issue guidelines for implementing patient and family engagement in healthcare systems which would enable healthcare providers to implement patient and family engagement and improve patient safety appropriately and effectively.
Topics: Family; Female; Humans; Male; Patient Safety; Patients
PubMed: 31588602
DOI: 10.1111/jan.14227 -
Journal of Advanced Nursing Jan 2023Critical illness and the intensive care unit can be a terrifying experience to patients and relatives and they may experience the extreme life-saving measures as...
BACKGROUND
Critical illness and the intensive care unit can be a terrifying experience to patients and relatives and they may experience the extreme life-saving measures as dehumanizing. Humanizing intensive care is often described as holism or dignity, but these abstract concepts provide little bodily resonance to what a humanized attitude is in concrete situations.
OBJECTIVE
To explore what contributes to patients' and relatives' experience of intensive care as humanized or dehumanized.
DESIGN
Thematic synthesis.
MATERIALS
Findings from 15 qualitative papers describing patients' and/or relatives' perceptions of humanizing or dehumanizing care.
METHODS
A systematic literature search of PubMed, CINAHL, Scopus and EMBASE from 1 January 1999 to 20 August 2022 identified 16 qualitative, empirical papers describing patients' and relatives' experiences of humanizing or dehumanizing intensive care, which were assessed using Critical Appraisal Skills Programme Qualitative Checklist, 15 papers were included and analysed using Thematic Synthesis and Ricoeur's model of the text.
FINDINGS
Intensive care was humanized when patients felt connected with healthcare professionals, with themselves by experiencing safety and well-being and with their loved ones. Intensive care was humanized to relatives when the patient was cared for as a unique person, when they were allowed to stay connected to the patient and when they felt cared for in the critical situation.
CONCLUSION
Patients and relatives experienced intensive care as humanized when healthcare professionals expressed genuine attention and supported them through their caring actions and when healthcare professionals supported patients' and relatives' opportunities to stay connected in the disrupted situation of critical illness. When healthcare professionals offered a connection to the patients and relatives, this helped them hold on and find meaning.
PATIENT OR PUBLIC CONTRIBUTION
No patient and public contribution.
Topics: Humans; Critical Care; Critical Illness; Family; Intensive Care Units; Patients; Qualitative Research
PubMed: 36281216
DOI: 10.1111/jan.15477 -
Nursing Open Oct 2023(1) To review and synthesize research on the contributions of nurses to rehabilitation in inpatient geriatric rehabilitation units (GRUs), and (2) to compare these... (Review)
Review
AIMS
(1) To review and synthesize research on the contributions of nurses to rehabilitation in inpatient geriatric rehabilitation units (GRUs), and (2) to compare these reported contributions to the domains of international rehabilitation nursing competency models. The roles and contributions of nurses (e.g. Registered Practical Nurses, Registered Nurses and Licensed Practical Nurses) in GRUs are non-specific, undervalued, undocumented and unrecognized as part of the formal Canadian rehabilitation process.
DESIGN
Arksey and O'Malley's methodological framework for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines were used.
METHODS
Six databases were searched for relevant literature: MEDLINE, PsychINFO, CINAHL, EMBASE, SCOPUS and Nursing and Allied Health. English articles were included if they examined nursing roles or contributions to inpatient geriatric rehabilitation. Integrated synthesis was used to combine the qualitative and quantitative data, and thematic analysis was used for coding. Three sets of international competency models were amalgamated to explore how different nurse roles in geriatric rehabilitation were portrayed in the included literature.
RESULTS
Eight studies published between 1991 and 2020 were included in the review. Five main geriatric rehabilitation nursing roles were generated from synthesis of the domains of international rehabilitation nursing competency models: conserver, supporter, interpreter, coach and advocate.
CONCLUSIONS
Nurses working in inpatient geriatric rehabilitation are recognized more for their role in conserving the body than their roles in supporting, interpreting, coaching and advocacy. Interprofessional team members appear to be less sure of the nurses' role in the rehabilitation unit. Nurses themselves do not acknowledge the unique rehabilitation aspects of care for older adults. Enhancing formal education, or adding continuing education courses, to facilitate role clarity for nurses in geriatric rehabilitation could improve nurses' and interprofessional healthcare team members' understandings of the possible contributions of nurses working in rehabilitation settings.
Topics: Humans; Aged; Inpatients; Canada; Nurse's Role; Geriatric Nursing; Nurses
PubMed: 37515319
DOI: 10.1002/nop2.1951