Improve Staff Attitudes Research Articles

Nurses' attitudes towards factors determining the safety of patients treated in intensive care units: A cross-sectional study.

The goal of health care systems is to ensure high quality of medical services provided, including patient safety. The intensive care unit (ICU) is an environment conducive to the occurrence of adverse events and medical errors because of the complexity of the care provided, the severity of the conditions of patients treated in these units and work often performed under stressful conditions. Assessment of attitudes of nurses working in ICUs towards patient safety. A cross-sectional, descriptive study was conducted in a group of 214 nurses employed in ICUs in hospitals located in the southern part of Poland. The study used the Polish version of the Attitudes towards safety: (SAQ-SF PL) questionnaire and an original questionnaire consisting of questions on socio-demographic and professional data. The overall SAQ score for the whole group was 61.89, 57.29 for adult ICU nurses and 68.20 for children's ICU. The surveyed nurses in general obtained the highest average results in terms of teamwork climate (TC)-66.92, while the lowest scores were given to the management-hospital management (PM)-45.08 and working conditions (WC)-57.56. job satisfaction (JS) positively correlated with the assessment of the TC, the assessment of the safety climate (SC), the assessment of the management staff (Head of Department) (PM), the assessment of the management staff (hospital management) (PM) and the assessment of work conditions (WC). A statistically significant, negative correlation was found between the assessment of JS and the assessment of stress recognition (SR) (r = -.20; p < .01). In the surveyed ICU branches, there is a low SC, and it is related, among others, to the perception of WC and the role of the management staff. The level of JS among nursing staff mainly depends on the SC, the TC, WC and the support of the management staff. The results of the research presented here provide valuable assistance in identifying areas related to patient safety in ICUs. Managers' awareness of the importance of coping with occupational stress, WC or effective teamwork can help to improve staff attitudes and attitudes towards patient safety. When shaping a safe culture in a health care organization, it is important to remember that ensuring safe patient care is not only about programmes, standards or procedures, but safety is primarily about human resources-the staff involved in the treatment process-doctors, nurses, paramedics and physiotherapists. High awareness of safety at work, cooperation in an interdisciplinary team, assessment of safety culture at work and analysis and drawing conclusions may result in a real increase in quality and safety, and the patient will feel safer in 'XX' hospitals.

Interdisciplinary Simulation Training Reduces Restraint Use in the Emergency Department: A Pilot Study.

Introduction Safe and effective management of agitated patients poses multiple challenges for healthcare professionals. Patients placed in restraints because of agitated behavior are at a higher risk of complications, including death. This intervention was designed to provide emergency department staff a framework for de-escalation, improve teamwork, and reduce the use of violent physical restraints. Methods Emergency medicine nurses, patient support associates, and protective services officers underwent a 90-minute educational intervention in 2017. A 30-minute lecture focusing on communication and early use of medication for agitation was followed by a simulationusing standardized participants, then a structured debriefing. A standardized return-on-learning tool determined participants' reactions to and application of the educational intervention.Additionally, data was collected and reported as a ratio of number of restraints applied each month compared to total emergency department visits that month. Data were analyzed comparing the six months before the education and the subsequent six months after the education. Results A pilot group of 30 emergency department staff members completed the educational intervention.The intervention contributed to the overall decrease in restraint use in the department.Most participants (86%) felt more confident in their ability to manage agitated patients. Conclusion An interdisciplinary simulation-enhanced educational intervention successfully reduced use of restraints in the emergency department and improved staff attitudes toward de-escalation techniques for agitated patients.

Perspectives on implementing exercise bikes for use by inpatient mental health staff in the workplace: A qualitative study investigating staff attitudes.

INTRODUCTION: Exercise equipment for mental health staff may improve staff wellbeing, mitigate against stress and improve staff attitudes towards physical activity. This said, there is a lack of researching investigating the attitudes of mental health staff towards the provision of fitness facilities in the workplace. The study investigated staff attitudes towards being offered exercise bikes in the workplace. Three focus groups and one individual interview were conducted with 12 healthcare professionals. Data were subject to a thematic analysis. Three themes were identified. (1) 'This sounds like a good idea', which reflected positive views in the provision of exercise in the workplace for staff use. (2) 'I'm not sure it would work because …', which reflected implementation concerns including not having access to shower facilities and time constraints. (3) 'Balancing choice', which reflected participant's desire to have access to varied gym equipment. The introduction of fitness facilities in the workplace for staff use was endorsed. However, implementation barriers were noted. This research provides justification for the exploration of the feasibility and benefits of providing exercise equipment for mental health staff in the workplace but presents implementation barriers that are worth considering before trialling provision of exercise equipment.

Why do we fear bottles and pacifiers?

Why do we fear bottles and pacifiers?

Perceptions of managerial staff on the patient safety culture at a tertiary hospital in South Africa

ABSTRACT Background Hospital managers are best suited and located to enhance patient safety culture within their institutions. Aim This study sought to provide insight on the perceptions of 10 managerial staff regarding the patient safety culture at a tertiary academic hospital in South Africa. Method In-depth interviews were conducted with strategic and operational managers within high-risk units in order to determinetheir perceptions regarding patient safety culture. Findings Participants described diverse aspects of the hospital’s patient safety culture including an overview of patient safety, implementation of patient safety initiatives, challenges to patient safety, current management of patient safety issues, as well as ways to improve the patient safety culture of the hospital. Conclusion The findings highlighted a number of areas to improve on to advance patient safety within the South African context. These include improving basic services, strengthening the infrastructure, improving staff attitudes and implementation of patient safety initiatives. Further research and development of quality improvement plans are essential to enhance patient safety.

Quality Improvement Initiative to Improve Healthcare Providers’ Attitudes towards Mothers with Opioid Use Disorder

Individuals with opioid use disorder often report feelings of shame and describe feeling judged negatively. These feelings are especially true for pregnant women with opioid use disorder. The Ohio Perinatal Quality Collaborative conducted a multimodal quality improvement initiative for infants born with Neonatal Abstinence Syndrome (NAS). An important component of the project was focused on improving staff attitudes toward mothers of infants with NAS. The Ohio Perinatal Quality Collaborative implemented an education program for healthcare providers at 39 participating hospital units regarding opioid use as a chronic disease and principles of nonjudgmental, trauma-informed care. Healthcare providers partnered with the mother of infants with NAS in the care of the infant and connected with local community resources. This work was a subcomponent of an overall multimodal quality improvement project. Healthcare provider attitudes were measured with the "Attitude Measurement: Brief Scales" questionnaire anonymously, at 3 different time points throughout the project. Attitude change was measured by pretraining and posttraining scores. ANOVA methods were used to compare individual items and a summary score across the 3 surveys. Summary scores improved significantly from 18.99 at baseline (January-March 2014) to 19.94 (P < 0.0001) in February 2015 and were maintained at 20.05 in July 2016. A nonjudgmental attitude toward mothers of infants with NAS is an important component of compassionate care. Improving healthcare provider attitudes can benefit a mother of an infant with NAS and help preserve the mother-infant dyad.

Managing patient aggression during registration: in preparation of implementing Affordable Care Act (ACA) 1557 intake questions

Health professionals face high rates of workplace violence from patients. This study systematically informed registration staff about pre-violent behaviors and tested its impacts on staff approaches to aggression. In this study, staff were concerned that the implementation of the new patient registration questions as mandated by the Affordable Care Act 1557 would cause patients to become aggressive. Using an open-ended questionnaire, this study involved the training of 74 staff at a Central California hospital who perform patient registration, in managing potential patient aggression during the new registration process and tested the effectiveness of the training. Results suggest that trainings are successful in helping staff identify pre-violent behaviors, use newly learned de-escalation strategies, and approach patient aggression from an appropriate perspective. Communication skill trainings are useful for teaching staff to identify patient pre-violent behaviors, and improving staff attitudes and approaches toward patient aggression. Hospitals should educate staff about the causes of patient aggression, and communication strategies to de-escalate. Lastly, staff should be encouraged to make external attributions for patient aggression.

The art of clinical supervision program: its impact on nurses attitudes towards nursing students

Background: Increasing health professional student numbers in Australia, in response to looming predicted workforce shortages, resulted in a Federal Government call for action to provide clinical supervision education to health professionals. Objectives: This research aimed to develop, implement and evaluate the programme, ‘The Art of Clinical Supervision’ (ACS), designed to support nurses facilitate a positive learning environment for student nurses. Method: The ACS programme was presented (n = 199) across Western Australia as a doctoral study, with participants from both the public and private healthcare sector working in a variety of specialties. A triangulation approach of surveys, reflective entries and interviews was utilised to determine its impact. Results: The data indicated that participants improved their understanding of supervision and attitude towards students and supervision after attending the ACS. Conclusions: Health service managers are encouraged to evaluate their staffs’ knowledge and attitude towards students with findings used to facilitate a positive learning culture.Impact Statement: The Art of Clinical SupervisionThe purpose of the research was to develop, implement and review a new education programme that could support the development of clinical supervision knowledge and attitude to support student nurse learning. This occurred in an environment of increased student numbers as a strategy to correct a predicted looming workforce shortage.The study findings determined that the programme improved both participant knowledge about how to provide effective clinical supervision (teaching) in the clinical environment, and improved staff attitudes towards students and their place as a learner in the clinical areas.The type of impact was therefore within the domain of quality by improving student learning through effective education strategy.As a result of the doctoral research, involving 200 participants, a Federal Government grant of approx. $500,000 was received to facilitate the training of additional educators to provide the programme across the state of Western Australia. This grant was a partnership between the programme author (researcher) and the Western Australian Government Department of Health. This involved four educators presenting the programme to over 3,000 health professionals in a 3-year period. Despite the cessation of funds with the closure of HWA the programme continues to be delivered through The University of Notre Dame Australia School of Nursing and Midwifery, with only a cost recovery charge.

Strengthening the Capacity of Education Staff to Support the Wellbeing of Indigenous Students in Boarding Schools: A Participatory Action Research Study

In meeting the social and emotional learning (SEL) needs of Aboriginal and Torres Strait Islander students, the capacities of school staff are critical. There is very limited evidence for relevant capacity development initiatives. This evaluation reports a multicomponent SEL training intervention delivered to staff of an Australian education service that operates independently of any particular school to assist with the transitions of students from remote communities to boarding schools. A participatory action research (PAR) approach was implemented over 13-months with 21 staff participants. Results from a pre-, mid- and six months post-training survey and staff interviews were analysed and fed back through reflective group discussions. The training was associated with improved staff attitudes to mental health and skills to support student wellbeing. Sixteen participants received a tertiary qualification. Despite ‘working in challenging environments’, staff were ‘dedicated to help’ students, and ‘acknowledged the need for change’ to better support student wellbeing. However, given the service's brokering role between families and schools, fewer staff members reported feeling empowered to influence issues in their workplace. The evaluation demonstrated the value of SEL training for education staff and potential utility for school teachers and boarding staff who have direct duty of care for Indigenous students. The multicomponent training described in this study would need to be condensed for school settings.

Factors Influencing Male Involvement in Antenatal Care in the Kassena Nankana Municipal in the Upper East Region, Ghana

Background: Globally, male involvement in antenatal care remains a challenge to the effective utilization of maternal health services. Male involvement is considered to be a useful tool that is capable of improving the health outcome of mothers and their children. However, matters relating to antenatal care have often been considered on a gender basis. Objective: The objective of this study was to assess the factors that influence male partner involvement in antenatal care services. Methods: A community-based crosssectional study was conducted among 420 men whose partners were pregnant or had delivered within twelve months preceding the study using multiple sampling procedures. Pearson Chi-Square and Fisher’s exact test were conducted to establish an association between dependent and independent variables after which multiple logistic regression was conducted. P-values of < 0.05 at 95% confidence interval were considered significant. Data were analyzed using STATA version 13.1. Results: The level of male involvement in antenatal care was high (67.2%). About 71.9% accompanied their partners to antenatal clinics at one point during the pregnancy period. Out of this, 45.7% of themdid so four or more times, 35.7% went two to three times, while 18.6% went only once. Factors such as staff attitude, time spent at the clinics, age, educational level, monthly income level, living with a partner during pregnancy, distance to the clinic, and community acceptability were all statistically significant to male involvement. Conclusion: The level of male involvement was high and considered above average. There is the need to develop interventions that will diffuse the existing socio-cultural perceptions and improve staff attitudes to achieve higher male involvement in antenatal care.

A facilitated approach to family case conferencing for people with advanced dementia living in nursing homes: perceptions of palliative care planning coordinators and other health professionals in the IDEAL study.

Palliative care for nursing home residents with advanced dementia is often sub-optimal due to poor communication and limited care planning. In a cluster randomized controlled trial, registered nurses (RNs) from 10 nursing homes were trained and funded to work as Palliative Care Planning Coordinators (PCPCs) to organize family case conferences and mentor staff. This qualitative sub-study aimed to explore PCPC and health professional perceptions of the benefits of facilitated case conferencing and identify factors influencing implementation. Semi-structured interviews were conducted with the RNs in the PCPC role, other members of nursing home staff, and physicians who participated in case conferences. Analysis was conducted by two researchers using a thematic framework approach. Interviews were conducted with 11 PCPCs, 18 other nurses, eight allied health workers, and three physicians. Perceived benefits of facilitated case conferencing included better communication between staff and families, greater multi-disciplinary involvement in case conferences and care planning, and improved staff attitudes and capabilities for dementia palliative care. Key factors influencing implementation included: staffing levels and time; support from management, staff and physicians; and positive family feedback. The facilitated approach explored in this study addressed known barriers to case conferencing. However, current business models in the sector make it difficult for case conferencing to receive the required levels of nursing qualification, training, and time. A collaborative nursing home culture and ongoing relationships with health professionals are also prerequisites for success. Further studies should document resident and family perceptions to harness consumer advocacy.

Evaluation of the 'Ladder to the Moon, Culture Change Studio Engagement Programme' staff training: Two quasi-experimental case studies.

To evaluate the impact of the CCSEP on care home staff in two care settings for older people in one nursing home and one residential home. Care homes provide personal care and accommodation for older people. The English Dementia Strategy aims to improve the quality of service provision for people with dementia. This includes specific mention of improving the quality of life in care homes and as such includes objectives related to developing the workforce knowledge and skills. The Ladder to the Moon Culture Change Studio Engagement Programme (CCSEP) is a staff training approach based on the Positive Psychology framework that uses theatre- and film-based activities. This study used a wait-list controlled design. However, the data analysis plan was amended to reflect difficulties in data collection, and a quasi-experimental case study approach was consequently utilised. Outcome measures for staff attitudes and beliefs were as follows: Sense of Competence in Dementia Care Staff; Approaches to Dementia Questionnaire; Job Satisfaction Index; Brief Learning Transfer System Inventory; and Scale of Positive and Negative Experience. The Quality of Interaction Schedule (QUIS) was used to observe changes in staff-resident interaction. Fifty staff in two care homes completed the questionnaires and forty-one undertook formal CCSEP training. In Home A (nursing home), there was no significant change in any of the measures. In Home B (residential home), the QUIS showed an increase in positive interactions post intervention; a significant increase in the Building Relationship subscale of Sense of Competence; and a significant increase in staff sense of hopefulness towards people with dementia. The Brief Learning Transfer System Inventory showed a significant decrease post-intervention. The intervention did not significantly affect the happiness or job satisfaction of care home staff. The results of this study provide tentative evidence about the efficacy of this staff training programme. Some significant improvement in staff attitudes to people with dementia, staff sense of competence and positive staff-resident interactions were found in one of two homes. It is likely that the organisational problems affecting the other care home limited the implementation and therefore efficacy of the intervention there. The results therefore suggest that when a supportive management structure is in place, CCSEP may be more effective in improving staff attitudes, sense of competence and interactions with residents.

Thematic analysis of barriers and facilitators to implementation of neonatal resuscitation guideline changes.

OBJECTIVETo evaluate experiences regarding implementation of Neonatal Resuscitation Program (NRP) guideline changes in the context of a collaborative quality improvement (QI) project.STUDY DESIGNFocus groups were conducted with local QI leaders and providers from 9 sites that participated in a QI collaborative. Thematic analysis identified facilitators and barriers to implementation of NRP guideline changes and quality improvement in general.RESULTSFacilitators for QI included comparative process measurement and data tracking. Barriers to QI were shifting priorities and aspects of the project that seemed inefficient. Specific to NRP, implementation strategies that worked involved rapid feedback, and education on rationale for change. Changes that interrupted traditional workflow proved challenging to implement. Limited resources and perceptions of increased workload were also barriers to implementation.CONCLUSIONSCollaborative QI methods are generally well accepted, particularly data tracking, sharing experience, and education. Strategies to increase efficiency and manage workload may facilitate improved staff attitudes toward change.

Job satisfaction and its relationship to Radiation Protection Knowledge, Attitude and Practice (RPKAP) of Iranian radiation workers.

This study aimed to find the association between job satisfaction and radiation protection knowledge, attitude and practice of medical radiation workers occupationally exposed to ionizing radiation. In this crosssectional study, 530 radiation workers affiliated to Tehran University of Medical Sciences completed a knowledge, attitude and practice questionnaire on protecting themselves against radiation and Job Descriptive Index as a job satisfaction measure during May to November 2014. Opportunities for promotion (84.2%) and payment (91.5%) were the most important factors for dissatisfaction. Radiation workers who were married, had more positive attitudes toward protecting themselves against radiation, and had higher level of education accounted for 15.8% of the total variance in predicting job satisfaction. In conclusion, medical radiation workers with a more positive attitude toward self-protection against radiation were more satisfied with their jobs. In radiation environments, improving staff attitudes toward their safety may be considered as a key strategy to increase job satisfaction.

Improving care for people with dementia: development and initial feasibility study for evaluation of life story work in dementia care

BackgroundImproving dementia care quality is an urgent priority nationally and internationally. Life story work (LSW) is an intervention that aims to improve individual outcomes and care for people with dementia and their carers. LSW gathers information and artefacts about the person, their history and interests, and produces a tangible output: the ‘life story’.ObjectiveTo establish whether or not full evaluation of LSW was feasible.DesignMixed-methods feasibility study.MethodsIn-depth interviews and focus groups explored experiences of LSW and best practice with people with dementia, family members and dementia care staff. A systematic review explored best practice and theories of change for LSW. These stages helped to identify the outcomes and resources to explore in the feasibility study. A representative sample survey of health and social care dementia care providers in England established LSW practice in different settings. A survey of a self-selected sample of family members of people with dementia explored how LSW is experienced. Two small outcome studies (stepped-wedge study in six care homes and pre-test post-test study in inpatient specialist dementia care wards) explored the feasibility of full evaluation of LSW in these settings.SettingsSurvey: generalist and specialist care homes; NHS dementia care settings; and community dementia services. Feasibility study: care homes and NHS inpatient dementia care wards.ParticipantsNHS and social care services, people with dementia, family carers, care home staff and NHS staff.InterventionsLSW.Main outcome measuresSpread of LSW and good practice, quality of life (QoL) for the person with dementia and carers, relationships between people with dementia and family carers, staff attitudes about dementia, staff burnout, resource use and costs.Review methodsNarrative review and synthesis, following Centre for Review and Dissemination guidelines.ResultsGood practice in LSW is identifiable, as are theories of change about how it might affect given outcomes. Indicators of best practice were produced. LSW is spreading but practice and use vary between care settings and are not always in line with identified good practice. Two different models of LSW are evident; these are likely to be appropriate at different stages of the dementia journey. The feasibility study showed some positive changes in staff attitudes towards dementia and, for some people with dementia, improvements in QoL. These may be attributable to LSW but these potential benefits require full evaluation. The feasibility work established the likely costs of LSW and highlighted the challenges of future evaluation in care homes and inpatient dementia care settings.LimitationsThere was insufficient evidence in the literature to allow estimation of outcome size. We did not carry out planned Markov chain modelling to inform decisions about carrying out future evaluation because of the dearth of outcome data in the literature; low levels of data return for people with dementia in the hospital settings; lack of detected effect for most people with dementia; and questions about implementation in the research settings.ConclusionsLSW is used across different health and social care settings in England, but in different ways, not all of which reflect ‘good practice’. This large, complex study identified a wide range of challenges for future research, but also the possibility that LSW may help to improve care staff attitudes towards dementia and QoL for some people with dementia.Future workFull evaluation of LSW as an intervention to improve staff attitudes and care is feasible with researchers based in or very close to care settings to ensure high-quality data collection.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Clients' satisfaction with HIV treatment services in Bamenda, Cameroon: a cross-sectional study.

BackgroundClients have explicit desires or requests for services when visiting hospitals; inadequate discovery of their needs may result in dissatisfaction. Patient satisfaction influences retention in HIV care, adherence to HAART and serves as determinant to HIV suppression. This study’s objectives were to quantify clients’ satisfaction with HIV services in Bamenda and determine relationship between satisfaction and clients’ socio-demographic/structural characteristics.MethodsA cross-sectional study was conducted on HIV-positive patients followed-up, on treatment and who consulted in the Bamenda Regional Hospital treatment centre between July and August 2014. Participants consent was sought and data collected on client’s level of satisfaction to staff-patient-communication, staff attitudes, privacy and confidentiality and staffing and amenities situations in the hospital. Data was collected using a structured questionnaire interviewer-administered by investigator and trained health personnel. Collected data was analyzed using Epi Info version 3.5.4 and clients’ satisfaction measured using frequencies and percentages.ResultsA total of 384 participants took part in this study and their median age was 37 years (IQR: 29-46). Two hundred and seventy-four (71.4 %) participants were females. Overall satisfaction with HIV services was 91.2 % and participants reported less satisfaction with overall staffing and amenities situation of the centre (3.6 %). In the multivariate analysis, only being female, employed and perceiving high number of nurses working at the treatment centre remained significant predictors of overall satisfaction with HIV services.ConclusionA high proportion of participants expressed satisfaction with HIV services. However, some dissatisfaction is masked in this high satisfaction level. This dissatisfaction underscores need to improve staff attitudes, staff-patient-communication, employ more staff and build better patient facilities. Future studies need to focus on assessing long-term progression of satisfaction levels with services and determinants of satisfaction involving larger samples in many treatment centres.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1512-5) contains supplementary material, which is available to authorized users.

Making an "Attitude Adjustment": Using a Simulation-Enhanced Interprofessional Education Strategy to Improve Attitudes Toward Teamwork and Communication.

Health care providers must effectively function in highly skilled teams in a collaborative manner, but there are few interprofessional training strategies in place. Interprofessional education (IPE) using simulation technology has gained popularity to address this need because of its inherent ability to impact learners' cognitive frames and promote peer-to-peer dialog. Provider attitudes toward teamwork have been directly linked to the quality of patient care. Investigators implemented a simulation-enhanced IPE intervention to improve staff attitudes toward teamwork and interprofessional communication in the emergency department setting. The 3-hour course consisted of a didactic session highlighting teamwork and communication strategies, 2 simulation scenarios on septic shock and cardiac arrest, and structured debriefing directed at impacting participant attitudes to teamwork and communication. This was a survey-based observational study. We used the TeamSTEPPS Teamwork Attitudes Questionnaire immediately before and after the session as a measurement of attitude change as well as the Hospital Survey on Patient Safety Culture before the session and 1 year after the intervention for program impact at the behavior level. Seventy-two emergency department nurses and resident physicians participated in the course from July to September 2012. Of the 5 constructs in TeamSTEPPS Teamwork Attitudes Questionnaire, 4 had a significant improvement in scores-6.4%, 2.8%, 4.0%, and 4.0% for team structure, leadership, situation monitoring, and mutual support, respectively (P < 0.0001, P = 0.029, P = 0.014, and P = 0.003, respectively). For Hospital Survey on Patient Safety Culture, 3 of 6 composites directly related to teamwork and communication showed a significant improvement-20.6%, 20.5%, and 23.9%, for frequency of event reporting, teamwork within hospital units, and hospital handoffs and transitions, respectively (P = 0.028, P = 0.035, and P = 0.024, respectively). A simulation-enhanced IPE curriculum was successful in improving participant attitudes toward teamwork and components of patient safety culture related to teamwork and communication.

Premorbid Concussion and its Effects on Recovery Following Traumatic Brain Injury (TBI)

the reinforcer being sought. DRO provided positive reinforcement for desired behaviors. Main Outcome Measure(s): Primary outcome measures include the number of perseverations per day, number of other challenging behaviors per day, positive statements per day and social contacts per week. Staff attitudes toward the subject were also measured at baseline and at every 3 months during treatment phase. Results: Results of study indicated that the intervention RIRD/DRO significantly reduced daily perseverative episodes, reducing incidents from an average of 5.33 episodes per day to .74 episodes per day after one year. There was also a significant reduction in other challenging behaviors that were identified as attention-seeking in nature. Results also demonstrated a significant increase in daily positive statements, weekly social contacts, and improved staff attitudes. Conclusions: In this case, the RIRD/DRO intervention was successful in reducing perseverative episodes. Simultaneously, other maladaptive behaviors were also reduced and replaced with more positive statements and social behaviors. As the subject became less perseverative, staff attitudes toward the subject improved which likely contributed to more successful interactions. This study is limited in its generalizability due to single-case design, but suggests that further investigation is warranted to determine if results can be replicated.

The attitudes of psychiatric hospital staff toward hospitalization and treatment of patients with borderline personality disorder.

BackgroundNegative attitudes towards patients with borderline personality disorder (BPD) may affect their treatment. We aimed to identify attitudes toward patients with BPD.MethodsClinicians in four psychiatric hospitals in Israel (n = 710; psychiatrists, psychologists, social workers and nurses) were approached and completed questionnaires on attitudes toward these patients.ResultsNurses and psychiatrists reported encountering a higher number of patients with BPD during the last month, and exhibited more negative attitudes and less empathy toward these patients than the other two professions. The whole sample evaluated the decision to hospitalize such a patient as less justified than the decision to hospitalize a patient with Major Depressive Disorder. Negative attitudes were positively correlated with caring for greater numbers of patients with BPD in the past month and in the past 12 months. Nurses expressed the highest interest in studying short-term methods for treating patients with BPD and a lower percentage of psychiatrists expressed an interest in improving their professional skills in treating these patients.ConclusionsThe findings show that nurses and psychiatrists differ from the other professions in their experience and attitudes toward patients with BPD. We conclude that nurses and psychiatrists may be the target of future studies on their attitudes toward provocative behavioral patterns (e.g., suicide attempts) characterizing these patients. We also recommend implementing workshops for improving staff attitudes toward patients with BPD.

Staff attitudes towards inpatients with borderline personality disorder

This article discusses the negative attitudes of some nursing staff towards inpatients diagnosed with borderline personality disorder (BPD), from the perspective of a third-year mental health nursing student. Factors to support underlying nurses? attitudes are considered, including stigma associated with BPD, the relationship between BPD and self-harm, clients being viewed as manipulative and nurses? lack of optimism for client recovery. Work pressures, poor communication skills and time restraints also contribute to the poor care being delivered by some mental health nurses.The authors suggest ways to improve staff attitudes, based on recommendations in the literature. Further education relating to BPD is discussed, as well as the need for increased supervision of mental health nurses and more time for effective communication between nurse, client and the multidisciplinary team.Double blind peer review