Improve Staff Attitudes Research Articles

Accesibilidad a tratamiento en personas con problemas de Alcohol y otras Sustancias de abuso

IATPAD (Improvement in Access to Treatment for People with Alcohol and Drug Related Problems) is a European study. The study's main objective was to detect barriers and facilitators associated with access to treatment among patients with problems related to alcohol and drug use. This article presents the quantitative findings from Cataluña (Spain). Multicentric, cross-sectional study. Three main treatment entry points were assessed: General Psychiatry (CSMA), Out-patient Addiction Centers (CAS) and Primary Care (CAP). Centres were randomly selected. The Medical Condition Regard Scale was used to measure regard for working with different patient groups (diabetes, depression, patients with problems related to alcohol and patients with problems related to drugs). Differences were detected in regard towards working with patients with alcohol, drugs and depression by treatment entry point. Professionals from the CASs reported higher regard towards working with substance users than professionals from CSMAs (p<0,001) or professionals from CAPs (p<0,001). The attitudes of professionals towards patients with substance use disorders are important for treatment engagement. Treatment policy needs to consider how to improve staff attitudes.

Interventions to improve teamwork and communications among healthcare staff

Concern over the frequency of unintended harm to patients has focused attention on the importance of teamwork and communication in avoiding errors. This has led to experiments with teamwork training programmes for clinical staff, mostly based on aviation models. These are widely assumed to be effective in improving patient safety, but the extent to which this assumption is justified by evidence remains unclear. A systematic literature review on the effects of teamwork training for clinical staff was performed. Information was sought on outcomes including staff attitudes, teamwork skills, technical performance, efficiency and clinical outcomes. Of 1036 relevant abstracts identified, 14 articles were analysed in detail: four randomized trials and ten non-randomized studies. Overall study quality was poor, with particular problems over blinding, subjective measures and Hawthorne effects. Few studies reported on every outcome category. Most reported improved staff attitudes, and six of eight reported significantly better teamwork after training. Five of eight studies reported improved technical performance, improved efficiency or reduced errors. Three studies reported evidence of clinical benefit, but this was modest or of borderline significance in each case. Studies with a stronger intervention were more likely to report benefits than those providing less training. None of the randomized trials found evidence of technical or clinical benefit. The evidence for technical or clinical benefit from teamwork training in medicine is weak. There is some evidence of benefit from studies with more intensive training programmes, but better quality research and cost-benefit analysis are needed.

Life stories and biography: a means of connecting family and staff to people with dementia

This article assesses the Family Biography Workshop (FBW) designed to support family and staff to co-construct the history of the person with dementia in residential care. Family-staff conflict in residential dementia care is a major stressor that disturbs effective relationships and contributes to stress. Biographical research has been found to improve communication and promote family-staff relations. Few studies focus on family biography as an approach that promotes positive relations that translate into inclusive care interactions. A qualitative descriptive approach was used to assess the influence of participation in the FBW and the impact of developing biographical knowledge on family-staff caregiver attitudes, perceptions of roles, conflict and the subsequent management of stress using participatory care practices. The FBW process involved seven family caregivers, seven staff and one researcher working collaboratively through a series of six weekly two-hour sessions, designed to help them build a biography of the person with dementia. For family caregivers, reviving memories of their relatives as 'whole' persons enabled some to 'stand outside' and see beyond the disease-saturated context. For staff, 'opening possibilities' of 'seeing' the resident within the family context empowered them to engage in genuine participatory practices. Residents benefited from being connected as staffs''know how' in initiating and engaging developed. Future research will examine the effects of the FBW on the dynamics of family-staff roles and relationships. This research aims to reduce stress from role inadequacy, task burden, poor relationships and improve staff attitudes towards family participation. This study substantiated the FBW by revealing understanding of the meaning of biography work for family and relatives in care; providing effective support that empowered staff to confidently relate; and fostering engagement in inclusive care practices that encouraged residents' initiatives.

Academic-State Hospital Collaboration for a Rehabilitative Model of Care

Academic-State Hospital Collaboration for a Rehabilitative Model of Care

Aggressive behaviour in the high‐secure forensic setting: the perceptions of patients

Twenty-seven patients undergoing treatment in a high-secure forensic facility participated in focus group interviews to elicit their perceptions of (1) the factors leading to aggressive behaviour; and (2) strategies to reduce the risk of such behaviour. The focus group interviews were audiotaped, transcribed and analysed using content analysis. The participants identified that a combination of patient, staff and environmental factors contributed to violence in the study wards. The cause of aggressive behaviour centred around five major themes: the environment; empty days; staff interactions; medication issues; and patient-centred factors. Potential strategies identified by patients to reduce aggressive behaviour included: early intervention; the provision of meaningful activities to reduce boredom; separation of acutely disturbed patients; improved staff attitudes; implementation of effective justice procedures; and a patient advocate to mediate during times of conflict. Findings suggested that social and organizational factors need to be addressed to change the punitive subculture inherent in forensic psychiatric facilities, and to ensure a balance between security and effective therapy.

Rabobank learns how to make employees into better professionals

PurposeTo highlight ways of improving staff attitudes to ethnic‐minority clients.Design/methodology/approachThe briefing is prepared by an independent writer who adds his own impartial comment and tries to place the article in context.FindingsGillert and Chuzischvili's article shows that employee beliefs play a more important part than specific intercultural “competencies” in helping staff to deal with ethnic‐minority clients more effectively. Change will be successfully achieved only if it is part of a larger process that causes employees to see that beliefs are not linked to any moralistic notion of having to be fair or non‐discriminatory, but to the very identity of a good professional in the organization. In this context, “on the job” training is more important than classroom instruction.Originality/valueThe article suggests key ways in which diversity training can be made more effective.

Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project.

To evaluate the effectiveness of training and institutionalizing teamwork behaviors, drawn from aviation crew resource management (CRM) programs, on emergency department (ED) staff organized into caregiver teams. Nine teaching and community hospital EDs. A prospective multicenter evaluation using a quasi-experimental, untreated control group design with one pretest and two posttests of the Emergency Team Coordination Course (ETCC). The experimental group, comprised of 684 physicians, nurses, and technicians, received the ETCC and implemented formal teamwork structures and processes. Assessments occurred prior to training, and at intervals of four and eight months after training. Three outcome constructs were evaluated: team behavior, ED performance, and attitudes and opinions. Trained observers rated ED staff team behaviors and made observations of clinical errors, a measure of ED performance. Staff and patients in the EDs completed surveys measuring attitudes and opinions. Hospital EDs were the units of analysis for the seven outcome measures. Prior to aggregating data at the hospital level, scale properties of surveys and event-related observations were evaluated at the respondent or case level. A statistically significant improvement in quality of team behaviors was shown between the experimental and control groups following training (p = .012). Subjective workload was not affected by the intervention (p = .668). The clinical error rate significantly decreased from 30.9 percent to 4.4 percent in the experimental group (p = .039). In the experimental group, the ED staffs' attitudes toward teamwork increased (p = .047) and staff assessments of institutional support showed a significant increase (p = .040). Our findings point to the effectiveness of formal teamwork training for improving team behaviors, reducing errors, and improving staff attitudes among the ETCC-trained hospitals.

Organ donation: a statewide survey of trauma surgeons.

Organ procurement organizations (OPOs) operate under the premise that Americans would donate organs and/or tissue if placed in appropriate circumstances. This study evaluated opinions of Pennsylvania trauma surgeons regarding OPOs and organ donation. Ninety-six Pennsylvania trauma surgeons were surveyed and descriptive results calculated. Ninety percent were familiar with criteria for organ donation, and about 76% would invoke their institution's brain death policy even if families did not desire to donate organs. A small portion did not routinely pronounce patients brain dead that met criteria. One fourth indicated trauma surgeons should have no role in requesting organs. A majority believed trauma surgeons should have a role in organ donation requests, either alone or with an OPO representative, and most indicated that they could influence a family's decision. Requestor attitude is important, and our results show an overall positive attitude toward donation and a solid level of knowledge regarding donor eligibility. Hospital development programs to improve donation consent should emphasize decoupling of brain death discussion and donation request, work to improve staff attitudes about approaching patients, and address donor eligibility criteria.