Patient Experience Of Care Research Articles

Collaboration between advanced practice nurses and physicians: a tool to enhance the care offered

The role of advanced practice nursing in France is still in its definition phase. While the prefiguration of the model was mainly in primary care, notably through the activities of the Asalée association, the first university graduates are mainly future hospital professionals, with a specialized orientation. Whether working in general or organ medicine, the advanced practice nurse (APN) is committed to making the patient's care experience more fluid, as part of a multi-professional team. Thanks to the acquisition of new skills and a structuring legal framework, collaboration between doctors and APNs is becoming a lace-making process, to best meet local needs.

The Lived Experience of Palliative Care Patients During the COVID-19 Pandemic

The Lived Experience of Palliative Care Patients During the COVID-19 Pandemic

Improving Barriers to Timely Colonoscopies: A New Approach to Overcoming Gaps in Medical Care.

This study investigates delays in transitioning from positive noninvasive multitarget stool DNA test results to scheduled diagnostic colonoscopies and identifies strategies aimed at improving patient care. A retrospective review revealed a 53% reduction in the average time from positive multitarget stool DNA test results to ordering colonoscopies postintervention. The findings demonstrate the significance of implementing a new communication system to expedite transitions in health care processes, showcasing its potential to significantly improve efficiency in patient care and health care provider workflows across various clinical testing scenarios. The findings emphasize the transformative impact of this communication system, shedding light on its ability to streamline processes and enhance patient care and staff experience.

Nurses’ experiences of caring for COVID-19 patients: A systematic review of qualitative studies

Background & Aim: Nurses are considered one of the most important members of the healthcare system in facing pandemics, including COVID-19. This study was conducted to explain the nurses' experiences in caring for patients diagnosed with COVID-19. Methods & Materials: This study was a qualitative systematic review. A structured search was conducted using CINAHL, MEDLINE, EMBASE, Pub Med, Google Scholar, Cochrane Library, MedNar, and ProQuest. All qualitative studies describing nurses’ experiences of caring for patients with Covid-19 were included. This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. Themes and narrative statements were extracted from included papers using the JBI SUMARI data extraction tool. Results: The findings of 46 qualitative studies were included in this systematic review. From the data analysis, four themes "Professional Development", "Psychological exhaustion", "Care Challenges" and "Work-family conflict" were extracted. Conclusion: Nurses have experienced conflicts between their work and family and challenges when caring for patients with COVID-19. Hence, they were psychologically under pressure but professionally developed. To ensure the survival of nurses in critical situations, all their needs must be carefully monitored and the necessary support provided to them.

Experiences of Patients Living with Peritoneal Dialysis: A Descriptive Qualitative Study

Background: Peritoneal dialysis is a renal replacement therapy in which individuals themselves manage their treatment processes. During this treatment, patients who receive peritoneal dialysis go through a lot of experiences. Objectives: The study aims to describe the experiences of patients receiving peritoneal dialysis. Methods: This study used a qualitative descriptive design. In-depth face-to-face interviews with the participants (n = 16) were conducted using semi-structured interviews. Data were analyzed using the content analysis method. Results: Three main themes emerged as a result of the content analyses: “experiences affecting adaptation”, “daily life activities”, and “emotional experiences”. Conclusion: Thanks to these learned experiences, nurses can give more individualized patient care. Arrangements can be made in areas that are difficult in daily life activities. Considering these experiences in patient care, they can facilitate the adaptation of the patient and help to cope with negative emotions.

Integrating accounting fintech innovations in the U. S. healthcare sector: opportunities, challenges, and impacts on financial management and patient care

Integrating accounting fintech innovations in the U.S. healthcare sector presents significant opportunities for enhancing financial management and patient care. This paper examines the current landscape of accounting fintech solutions in healthcare, highlighting key opportunities, challenges, and impacts on financial management and patient care. The healthcare industry is increasingly adopting fintech innovations to streamline financial processes, improve efficiency, and enhance patient care. Accounting fintech solutions such as automated billing and payment systems, blockchain technology for secure transactions, and predictive analytics for financial forecasting are revolutionizing financial management practices in healthcare organizations. However, integrating accounting fintech innovations in the healthcare sector also presents several challenges. These include concerns about data security and privacy, the need for regulatory compliance, and the potential for disruption to traditional financial management practices. Addressing these challenges will be crucial to realizing the full potential of accounting fintech in healthcare. The impact of integrating accounting fintech innovations in the U.S. healthcare sector is significant. Improved financial management practices can lead to cost savings, increased revenue, and better resource allocation, ultimately benefiting both healthcare organizations and patients. Additionally, enhanced financial transparency and efficiency can lead to improved patient care outcomes and experiences. In conclusion, integrating accounting fintech innovations in the U.S. healthcare sector offers numerous opportunities for improving financial management and patient care. However, this integration also presents challenges that must be addressed to realize these benefits fully. By overcoming these challenges and leveraging the potential of accounting fintech, healthcare organizations can enhance their financial management practices and provide better care to their patients.

Assessing Student-Reported Perceptions of Prerequisite Usefulness in Preparation for Didactic Physician Assistant Education.

To gain admittance to a physician assistant (PA) school, applicants must complete program-specific prerequisite courses and experiences. The lack of standardization contributes to complexity, expense, and limits diversity. This research assessed current didactic PA students' perceptions of prerequisite courses, course delivery methods, and direct patient care (DPC) experiences to determine which were perceived as the most useful in preparation for didactic PA education. An online cross-sectional survey was sent to eligible PA students across the United States. The survey collected opinions on the usefulness of commonly required prerequisite courses, course delivery methods, and DPC experiences. Collected data underwent statistical analysis and qualitative analysis for open-response questions. A total of 527 students completed the survey. Greater than 50% reported prerequisite courses in science and psychology as well as speech, ethics, cardiopulmonary resuscitation (CPR), medical ethics, medical terminology, and nutrition "prepared them well" or "extremely well." The most frequently recommended educational delivery method was "in person." The DPC experiences reported to best prepare students were Medical Assistant, Certified Nursing Assistant, and Scribe. The reported recommended number of DPC hours was 1000 to 1499. Chi-square tests for courses that prepared students "well" and "extremely well" revealed that in-person delivery had a statistically significant association with anatomy, physiology, ethics, CPR, medical ethics, and Spanish. These significant findings should be considered by PA programs when evaluating their requirements for admission. Furthermore, PA education associations should consider universal requirements to reduce applicant barriers, complexity, and expense, which may lead to improved diversity.

Analysis of the dimensions of health service quality on patient satisfaction in the polyclinic of surgical sub-specialists of Royal Prima Hospital Medan, the Year 2024

This study focuses on evaluating how different dimensions of health service quality impact patient satisfaction at Royal Prima Medan Hospital's Sub-Specialist Surgery Polyclinic in 2024. Understanding patient satisfaction is crucial as it reflects their expectations, needs, and assessments of the care received, ultimately influencing their loyalty and the hospital's reputation. Using a quantitative non-experimental approach with descriptive and associative analyses, the study involved 133 patients at the polyclinic, with a sample of 60 respondents selected incidentally. Data collection methods included interviews, questionnaires, and secondary data from the hospital. The variables studied were Service Satisfaction, Tangible aspects, Reliability, Responsiveness, Assurance, and Empathy. Ethical considerations were paramount, with approvals from the Health Research Ethics Commission and obtaining Informed Consent from informants/respondents. Validity and reliability tests were conducted on research instruments to ensure data quality. Statistical analysis using Chi-Square tests and multiple logistic regression revealed significant correlations between Reliability, Assurance, Appearance, Responsiveness, Empathy, and Patient Satisfaction. Among these, Empathy emerged as the most influential factor, highlighting the importance of communication, strong relationships, and understanding patient needs in healthcare settings. In conclusion, this study underscores the critical role of service quality dimensions in enhancing patient satisfaction, offering insights for healthcare providers to improve care delivery and patient experiences at Royal Prima Medan Hospital's Sub-Specialist Surgery Polyclinic.

Role of the addiction clinical nurse specialist in acute hospital settings.

The role of an addiction clinical nurse specialist (ACNS) is focused on individuals who misuse drugs and alcohol, and several benefits of the role have been identified in the literature. When people who misuse substances are admitted to acute general hospitals, there is an opportunity to engage with them and ensure they access support services to facilitate their recovery. To determine general nurses' experience of caring for patients who misuse substances, and to gauge nurses' views on the implementation of an ACNS role in an acute general hospital. This study used a qualitative design involving online interviews with 11 hospital nurses. Many participants felt that an ACNS could provide them with education and support around substance misuse, while also advocating for patients who misuse substances, reducing stigma and enhancing patient care. Participants indicated several benefits to implementing an ACNS role in their hospital, such as ensuring that patients who misuse substances experienced continuity of care which began at admission, was followed-up during inpatient stays and was maintained in the community.

Supporting patients with venous leg ulcers in self-care monitoring: an interview study with primary health care professionals

Objective This study described the experiences and perceptions of how primary health care professionals (PHCPs) support patients with venous leg ulcers (VLUs) in self-care monitoring. Design A qualitative approach with reflexive thematic analysis was used, with 24 individual qualitative open interviews. Setting Primary health care clinics and community health care in four southern regions in Sweden. Subjects Registered nurses, district nurses and nurse assistants who had experience of caring for patients with VLUs. In total, 24 interviews were conducted with PHCPs in Sweden. Results PHCPs have a vital role in promoting patient independence and responsibility, identifying needs and adapting care strategies, while also recognising unmet needs in patients with VLUs. Conclusion PHCPs actively monitor patients’ self-care and establish caring relationships. They see a need for a structured primary health care work routine for ulcer management.

Emergency nurses' experience in caring for unidentified patients: A qualitative study

ObjectiveTo describe and analyse emergency nurses' experiences of caring for unidentified patients, and to provide a basis for constructing processes and standards of care for unidentified patients in the emergency department. MethodsThis study is a descriptive phenomenological research that utilized purposive sampling. Sixteen emergency department nurses, who cared for unidentified patients between June and September 2023, were selected for semi-structured face-to-face interviews. Data were analyzed using Colaizzi's 7-step method to identify and refine themes. ResultsThree themes were distilled: (1) increased workload, (2) increased mental stress at work, and (3) material needs and external environmental support. ConclusionEmergency nurses have more complex negative emotional experiences when dealing with unidentified patients and want more external support to cope with such patients. Hospital administrators should pay full attention to nurses' caregiving experiences and provide positive interventions.

Consistency and Sustainability of Home Health Agency Patient Experience Star Rating Performance and the Association With Joint Commission Accreditation

Accreditation seeks to improve the quality of health care, 1 dimension of which is patient experience. The Home Health Consumer Assessment of Healthcare Practitioners and Systems (HHCAHPS) survey collects patient care experience data in home health agencies (HHAs). This study examined the association between accreditation and the consistency and sustainability of high patient experience ratings between Joint Commission (TJC)-accredited and non-TJC accredited HHAs. This multi-year observational study analyzed HHCAHPS star rating performance data from 2015 to 2019. The 5 measures included are based on the 3 publicly reported composite measures, the global measure, and a Star Summary measure. Each measure receives a star rating from 1 to 5. A total of 7230 HHAs reported star rating data between 2015 and 2019, with 4099 (56.7%) having data spanning all 5 years. Of these, 959 (23.4%) were TJC-accredited and 3140 (76.6%) were not. A star rating score of 4 or 5 was considered high performing. TJC-accredited (vs non-TJC accredited) organizations had a higher proportion of HHAs with all 5 years with a high rating ( p < .05 for all measures). Among those HHAs who were in the top rating category the previous year, TJC-accredited (vs non-TJC accredited) HHAs had an even higher probability of sustaining the top rating category in the current year ( p < .001 for all measures). These findings suggest that TJC accreditation is associated with consistently high HHCAHPS star ratings over time. This association was strongest for the Specific Care Issues measure where the concepts addressed by the measure overlapped with topics addressed by accreditation standards.

General practice management after transition events: protocol for an experience-based co-design study.

Discharge from hospital is a critical part of the patient journey, particularly for older patients with multimorbidity and polypharmacy. General practice has a key role in managing the post-discharge course of patients. A communication intervention for use in general practice in the immediate post-discharge period has great potential to improve shared decision making, enhancing patient experiences of post-discharge care. General Practice Management After Transition Events (GP-MATE) aims to produce a tool for older patients and their carers (GP-MATE), which will assist better communication with their general practice about their care after discharge, thereby improving patient safety outcomes. Experience-based co-design (EBCD) study involving general practices across the West Midlands. A slightly modified approach to EBCD will be followed to create GP-MATE. A focused ethnography undertaken at general practices will provide an understanding of practices' systems for post-discharge management of older patients. Semi-structured video interviews with recently discharged older patients or their carers will be edited into a trigger film. Finally, co-design workshops with older people, carers, and healthcare staff working in general practices will take place with participants from three regions across England. EBCD will be used to take a patient-centric approach towards creating GP-MATE; patients' and carers' priorities will be directly reflected within the tool. GP-MATE will be a low-cost intervention that improves health literacy, empowering patients to fill the emerging gap in continuity in the post-discharge period and enhancing patient experiences of post-discharge care.

Patients’ perioperative experiences of an opioid-free versus opioid-based care pathway for laparoscopic bariatric surgery: A qualitative study

BackgroundDespite recent evidence supporting the adoption of opioid-free anaesthetic and analgesic alternatives in the perioperative context, opioid-based regimens remain standard of care. There is limited knowledge about the patients’ perioperative experiences of bariatric surgery, with no study yet investigating their experiences within an opioid-free care pathway. ObjectiveWe aimed to describe similarities and differences in patients’ perioperative experiences of undergoing bariatric surgery with either an opioid-free or opioid-based care pathway. DesignA qualitative interview study SettingA strategic sample of patients enrolled in an ongoing randomized controlled trial investigating the effects of opioid-free anaesthesia for bariatric surgery were recruited. In the randomized controlled trial, participants were randomized to either opioid-based anaesthesia or opioid-free anaesthesia, including transcutaneous electrical nerve stimulation as primary postoperative pain management. ParticipantsTwenty patients were interviewed 3 months after surgery: 10 participants in the opioid-free group versus 10 in the opioid-based group. MethodsSemi-structured interviews were conducted between December 2020 and February 2022 and analysed with qualitative content analysis. ResultsThe analysis yielded four categories and 12 subcategories. In Category 1, participants shared diverse emotions before surgery, including anticipation of a healthier life, but also apprehensions and feelings of failure. In Category 2, describing liminality of general anaesthesia, there were similar descriptions of struggling to remember the anaesthesia induction and struggling to surface when recovering from anaesthesia. However, some participants in the opioid-free group shared descriptions of struggling to keep control, describing accentuated memories of the anaesthesia induction. Category 3, managing your pain, showed similar experiences and strategies but different narrations of pain management, with the opioid-free group stating that transcutaneous electrical nerve stimulation works but not when it really hurts, and the opioid-based group describing confidence in but awareness of opioids. Throughout the overall perioperative time period, participants acknowledged Category 4, a patient-professional presence, stating that preparations boost the feeling of confidence before surgery and that they felt confidence in a vulnerable situation although vulnerability challenges communication. ConclusionsWe highlighted the overall similarities in perioperative experiences of patients undergoing bariatric surgery. However, the differences in experiences during opioid-free anaesthesia induction need to be addressed in further implementation and research studies investigating strategies to reduce the sense of loss of control. More research is needed to facilitate the implementation of opioid-free treatment strategies into clinical practice and improve the patient care experience.

‘Sit down and thrash it out’: opportunities for expanding ethics consultation during conflict resolution in long-term care

Objective: To identify the frequency and nature of care conflict dilemmas that United States long-term care providers encounter, response strategies, and use of ethics resources to assist with dispute resolution. Design: An online cross-sectional survey was distributed to the Society for Post-Acute and Long-Term Care Medicine (AMDA). Results: Two-thirds of participants, primarily medical directors, have rejected surrogate instructions and 71% have managed family conflict. Conflict over treatment decisions and issues interpreting advance directives were frequently reported. Half of facilities lack a formal dispute mediation policy. Only five respondents have called an ethics consult for assistance. Conclusion: Ethically tense care conflicts commonly arise in long-term and post-acute care facilities. Few facility procedures incorporate ethics resources into actual practice. Recommendations are made to create actionable policy, increase access to ethics services, and support staff skill development in order to improve the end-of-life care experiences for patients, families, and care facility staff.

Framework for an interprofessional experience addressing health and disability for health professional students

Background and purposeA Health and Disabilities Interprofessional Education (IPE) course was implemented to join three healthcare disciplines together to collaboratively plan, implement, and reflect on professional roles and responsibilities. The goal and purpose of this course was to create an advancement of interprofessional education and practice within health science professions early in their students' programs utilizing innovative teaching methods working directly with individuals with disabilities. Educational activity and setting72 students were assigned to interprofessional teams of 10–11 people. Through asynchronous and synchronous learning activities, student teams worked together to plan and conduct community-based client interviews. FindingsQuantitative and qualitative evaluation methods were used to explore the impact of interprofessional experiential learning experiences. Qualitative data showed a greater awareness and understanding of the different roles and responsibilities in interprofessional teams as well as a greater appreciation for the value of interacting with persons with disabilities (PWD) during their training. Quantitative data showed a significant change in students' understanding of their roles and responsibilities as a member of an interprofessional team, their confidence with working with PWD in a future healthcare capacity, as well as their understanding of how the social determinants of health may influence the healthcare experience of a PWD. SummaryInterprofessional education and experiential learning opportunities are good ways to facilitate “real” patient care experiences and team roles and responsibilities. This enables healthcare students to practice communication, build relationships, and understand the lived experience of their patients.

Empowering Nurses for High-Value Healthcare: A Call for Legislative and Systemic Change.

Recognizing the positive impact of clinical data outcomes and patient care experiences, coupled with the growing preference for advanced practice RNs among patients, it is imperative that nurse leaders propel legislative reforms and infrastructure support from health systems. This strategic approach is crucial for maximizing the potential of nurses in improving patient care experience and outcomes, as well as increasing accessibility to healthcare in every community.

64 Variability in patient pathways and experiences of care in peritoneal mesothelioma

64 Variability in patient pathways and experiences of care in peritoneal mesothelioma

The clinical gaze: Its power and purpose in determining the patient experience and the value of interpersonal and technical skills in medicine

AbstractCurrent health education typically prizes and prioritises a biomedical sensibility in clinical practice, often to the detriment of the patient experience. In exploring the impact of the clinical gaze on patient experiences of medical care, this article argues for integrating interpersonal and technical skills in modern medicine, emphasising the value of holistic and compassionate care.

204 Advancing our Communal Understanding of Rectal cancer Disparities and Identifying Opportunities for Improvement (ACUeRDO)

OBJECTIVES/GOALS: Mechanisms underlying racial and ethnic disparities in rectal cancer care remain poorly understood. We aimed to identify barriers and facilitators to care among rectal cancer patients who identify as Hispanic/Latino (H/L) and to understand how these factors may differ based on rurality, social/physical context, and community support. METHODS/STUDY POPULATION: We utilized qualitative methods and a community-based participatory research framework, including partnership with a community-based organization and oversight from a community advisory board. We developed an initial semi-structured interview guide based on an ecological model of health behavior and then iteratively refined it with the assistance of our partners to incorporate unique aspects of the H/L community in a culturally appropriate manner. Eligible patients and their caregivers are invited to participate in hour-long interviews in both English and Spanish, depending on participants’ preferences. All interviews are recorded, translated, transcribed, and coded. Findings will be compiled and fed back to participantsand community stakeholders as a part of a community forum. RESULTS/ANTICIPATED RESULTS: We identified 6 areas for discussion based on our model: health beliefs (perceived severity, benefit, and barriers; self-efficacy), health literacy, others’ experiences with cancer, patient-provider relationship (patient-provider communication; provider-provider communication; language; cultural competency; discrimination), sources of support, and access to care. Participants are currently being recruited by clinical providers, through flyers in the cancer center, or via outreach from our community partner. We have interviewed 8 participants to date, with discussions ranging from the shock of the initial diagnosis, difficulties with navigating specialty care, and the complexities of shared decision making. We are expecting a total of 30-40 interviews to reach thematic saturation. DISCUSSION/SIGNIFICANCE: We hope to improve our understanding of mechanisms underlying racial and ethnic disparities in rectal cancer care and to identify potential targets for improvement. We plan to use our results to develop community-based policy interventions to improve care delivery, patient experience, and health equity.