Patient Care Practice Research Articles

Opinions and Experiences of Foreign Student Nurses Regarding Patient Care Practices in Türkiye: A Qualitative Study

Aims : We aimed to identify the unique challenges and opportunities faced by international student nurses in Türkiye when practicing patient care. This understanding is essential for educators, healthcare institutions, and policy makers to create more inclusive and supportive environments that enhance learning and professional development. Addressing these challenges can lead to better integration of foreign student nurses into the healthcare system, ultimately improving patient care quality. This research is important for all stakeholders in healthcare - educators, administrators, policymakers, and patients - because a diverse and well-supported nursing workforce is essential for the delivery of culturally competent and high-quality care. Methods : This study employed interpretative phenomenology. Data were collected from 12 foreign nursing students from Iraq, Egypt, Syria, Saudi Arabia, Iran, and the Netherlands. Data were collected between 01 and 20 May 2023 in the Nursing Department of the Faculty of Health Sciences of a state university in the province of Şanlıurfa, located in the southeastern region of Türkiye. Data were analyzed using Colaizzi’s method. Results : We identified four themes: “Metaphors describing patient care practices,” “Factors affecting care practices,” “Needs for education and support,” and “Opportunities during patient care practices.” Positively influencing factors included better education and living standards and economic benefits, while negatively influencing factors were traumatic events before studying abroad, racial discrimination, language and cultural differences, negative emotions, peer victimization, and lack of use of standards. Interviewees reported a need for training and support and that patient care practices provided opportunities for greater awareness, responsibility, and professional integration. Discussion : Positive and negative experiences of foreign student nurses were evident in the delivery of patient care practice. Interventions are needed to alleviate negatively influencing factors, provide training and support for students, and improve opportunities for foreign nationals. Identification of these factors can help medical educators to develop culturally sensitive and inclusive approaches, as well as individual/organisational facilitators that enhance existing opportunities and remove barriers.

The Impact of Ketamine-Based Versus Non-Ketamine-Based ECT Anesthesia Regimens on the Severity of Patients’ Depression and Occurrence of Adverse Events: A Systematic Review with Meta-Analysis

Objective: To compare efficacy and safety outcomes for ketamine anesthesia + electroconvulsive therapy (ECT) versus nonketamine anesthesia + ECT in treatment-resistant depression (TRD) patients. Data Sources: PubMed and Embase were searched from the earliest date through November 27, 2023. Study Selection and Data Extraction: Relevant randomized controlled trials (RCTs) of ketamine + ECT versus nonketamine anesthesia + ECT that reported data on remission (odds ratio [OR]), defined as a Hamilton Depression Rating Scale (HAM-D) and Montgomery-Asburg Depression Rating Scale (MADRS) score <8-10) and mean differences (MDs) in HAM-D scores after several ECT sessions were compared using inverse variance methods. The risk of bias (RoB) was assessed using the Cochrane RoB tool. Data Synthesis: Seventeen RCTs (RoB: Low N = 12, Moderate N = 2, High N = 3) with 1181 total patients met inclusion criteria. Patients receiving ECT experienced greater clinical remission (OR: 1.78, [95% confidence interval (CI): 1.08-2.93], I2 = 11%, N = 9) and lower HAM-D scores after the third through sixth ECT sessions as well as the eighth ECT session when ketamine versus nonketamine anesthesia was used. Ketamine use with ECT significantly increased fear with hallucinations (OR: 1.99, [95% CI: 1.11-3.58], I2 = 0%, N = 7) than with nonketamine anesthesia. Relevance to Patient Care and Clinical Practice: Selecting ketamine-based anesthesia could more quickly and profoundly enhance the beneficial effects of ECT for patients with severe TRD, but the balance of benefits to harm is unclear as there may be additional adverse events. Conclusion: Ketamine is a promising anesthesia adjunct to ECT that may enhance antidepressant effects in exchange for more adverse events.

Surgical management of chest injuries in patients with multiple and/or severe trauma- a systematic review and clinical practice guideline update.

Our aim was to update evidence-based and consensus-based recommendations for the surgical and interventional management of blunt or penetrating injuries to the chest in patients with multiple and/or severe injuries on the basis of current evidence. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Multiple and/or Severe Injuries. MEDLINE and Embase were systematically searched to May and June 2021 respectively for the update and new questions. Further literature reports were obtained from clinical experts. Randomised controlled trials, prospective cohort studies, cross-sectional studies and comparative registry studies were included if they compared interventions for the surgical management of injuries to the chest in patients with multiple and/or severe injuries. We considered patient-relevant clinical outcomes such as mortality, length of stay, and diagnostic test accuracy. Risk of bias was assessed using NICE 2012 checklists. The evidence was synthesised narratively, and expert consensus was used to develop recommendations and determine their strength. One study was identified. This study compared wedge resection, lobectomy and pneumonectomy in the management of patients with severe chest trauma that required some form of lung resection. Based on the updated evidence and expert consensus, one recommendation was modified and two additional good practice points were developed. All achieved strong consensus. The recommendation on the amount of blood loss that is used as an indication for surgical intervention in patients with chest injuries was modified to reflect new findings in trauma care and patient stabilisation. The new good clinical practice points (GPPs) on the use of video-assisted thoracoscopic surgery (VATS) in patients with initial circulatory stability are also in line with current practice in patient care. As has been shown in recent decades, the treatment of chest trauma has become less and less invasive for the patient as diagnostic and technical possibilities have expanded. Examples include interventional stenting of aortic injuries, video-assisted thoracoscopy and parenchyma-sparing treatment of lung injuries. These less invasive treatment concepts reduce morbidity and mortality in the primary surgical phase following a chest trauma.

Self-Compassion and its Relationship with Patient Care Practices among Nurses

Background: The healthcare industry continuously explores factors that contribute to the effective delivery of patient-centered care amidst global concerns about healthcare worker shortages and maintaining a healthy workforce. Self-compassion has been recognized as a significant factor that enhances empathy, reduces professional burnout, and improves the quality of life in healthcare settings. Objective: This study aims to examine the influence of self-compassion on patient care practices among nurses, considering demographic variables such as age, marital status, and work experience to identify actionable factors that enhance care quality. Methods: A cross-sectional correlational survey was employed, involving 403 female nurses from various hospitals in Islamabad and Faisalabad, aged between 20 and 55 years. The Self-Compassion Scale (Urdu version) and the Caring Behaviors Inventory-24 (Urdu version) were used to measure self-compassion and patient care practices, respectively. Demographic data were collected through a structured questionnaire. Statistical analysis included regression, t-tests, and ANOVA, conducted using SPSS version 25.0, to assess relationships and group differences based on the collected data. Results: Self-compassion explained 23% of the variance in patient care practices (F = 119.09, p < .01). Nurses with more than 10 years of experience demonstrated better patient care practices compared to those with less experience. Unmarried nurses showed higher levels of self-compassion and better patient care practices compared to their married counterparts. Conclusion: The findings underscore the positive relationship between self-compassion and patient care practices, suggesting that enhancing self-compassion among nurses can lead to improved healthcare delivery. Promoting self-compassion training and practices in healthcare settings could enhance professional development, increase resilience, and subsequently improve patient outcomes.

Reserving the human touch in nursing education while integrating virtual reality and simulation

In the ever-evolving landscape of nursing education, the integration of virtual reality (VR) and simulation technologies presents both promise and challenges. Although these innovative tools offer unparalleled opportunities for skill acquisition and clinical reasoning, concerns have arisen regarding the potential erosion of compassionate care at the core of nursing practice. The article explores the balance between technical proficiency and compassionate care in nursing education. The importance of comprehensive educator training in utilizing VR and simulation to instill humanistic values, along with the need for curriculum development that seamlessly integrates compassionate care throughout nursing programs, is underscored. By emphasizing the integration of empathy, emotional intelligence, and reflection into VR and simulation experiences, nursing education can ensure that graduates possess the skill sets and values essential for patient-centered practice. The preservation of human touch remains a priority and a cornerstone in the preparation of nursing professionals equipped to deliver holistic and empathetic care in an increasingly technology-driven healthcare landscape.

Endoscopic Spine Surgery on Instagram: Analysis of Content and Engagement.

Introduction Social media platforms have changed the way society communicates and collaborates. Prior research in healthcare discusses how social media can empower patients, dispel health-related misinformation, and help maintain a patient-centered practice. The goal of this study was to evaluate the use of #endoscopicspinesurgery on Instagram and create a blueprint for creating engaging posts on the social media platform. Methodology Public Instagram posts (n= 171) that utilized #endoscopicspinesurgery were collected over three months in 2022. Each post was assessed for photo and caption content, likes, comments, number of followers, and hashtag information. Engagement rates were calculated for each post to assess the active interaction of post characteristics and content. Results The majority of posts were published by medical professionals (72/171, 42.1%) and industry-related user accounts (55/171, 32.2%). Content related to training, conferences, and the operating room garnered the highest average engagement. Post characteristics (number of hashtags and number of post photos) were significantly associated with engagement. Conclusions Results highlighted general trends in creating engaging social media posts, such as using hashtags intentionally to increase searchability and visibility, having higher numbers of photos in a post and using high-quality photos, and understanding the dynamic social media algorithms that may affect post viewership. When structuring social media posts, users should be aware of the audience they want to attract and construct their content accordingly.

Leveraging ChatGPT to optimize depression intervention through explainable deep learning.

Mental health issues bring a heavy burden to individuals and societies around the world. Recently, the large language model ChatGPT has demonstrated potential in depression intervention. The primary objective of this study was to ascertain the viability of ChatGPT as a tool for aiding counselors in their interactions with patients while concurrently evaluating its comparability to human-generated content (HGC). We propose a novel framework that integrates state-of-the-art AI technologies, including ChatGPT, BERT, and SHAP, to enhance the accuracy and effectiveness of mental health interventions. ChatGPT generates responses to user inquiries, which are then classified using BERT to ensure the reliability of the content. SHAP is subsequently employed to provide insights into the underlying semantic constructs of the AI-generated recommendations, enhancing the interpretability of the intervention. Remarkably, our proposed methodology consistently achieved an impressive accuracy rate of 93.76%. We discerned that ChatGPT always employs a polite and considerate tone in its responses. It refrains from using intricate or unconventional vocabulary and maintains an impersonal demeanor. These findings underscore the potential significance of AIGC as an invaluable complementary component in enhancing conventional intervention strategies. This study illuminates the considerable promise offered by the utilization of large language models in the realm of healthcare. It represents a pivotal step toward advancing the development of sophisticated healthcare systems capable of augmenting patient care and counseling practices.

Comparison of Implant-Retained Overdenture and Conventional Complete Denture: A Survey Study to Measure Patients' Satisfaction and Quality of Life in Dental School Clinics.

Patient satisfaction and quality of life are integral to assessing oral health care quality. For many Americans still using conventional complete dentures (CDs) or implant-retained mandibular overdentures (IODs), it remains essential to consider improving their oral health outcomes and quality of life. Due to inexperienced student dentists providing dental care to dental school patients, patient grievances are generally considered a problem. Patient feedback and satisfaction have proven valuable resources for monitoring and improving patient safety. While CDs and IODs are the 2 leading treatment options for edentulism, more comparative studies in the literature need to compare their outcomes in a school setting. The research question that guided this comparative analysis was, "Is patient satisfaction and quality of life affected by the type of prostheses and provider?" A validated questionnaire was mailed to 520 individuals selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the University of Kentucky College of Dentistry from 2014 to 2016 with at least 1 year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients' oral health-related quality of life, including questions related to the edentulous patients' satisfaction with their dentures, was collected. The response rate was 33% (N = 171). The study's findings confirm previous findings, suggesting that IODs may significantly impact oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IODs had lower physical pain, limitations, and disability scores than males with CD. However, females with IODs reported more significant concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned essential characteristics that contribute to increased patient satisfaction with IODs and identified significance in outcomes by gender. These findings guide prosthodontic practitioners' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula.

Exploring Nursing Students' First Experiences Providing Wound and Ostomy Care to Patients: A Qualitative Study.

Undergraduate nursing students experience significant differences between practice with models, manikins, or simulation applications and real patients in a clinical setting. Students' experiences applying their theoretical knowledge to real patient-care practices are little understood. To determine the experiences of nursing students in providing skin, chronic wound, and ostomy care to real patients for the first time in a clinical setting within the content of the Ostomy and Wound Care Nursing Track Program (OWCNTP) and to define factors affecting this program. The research was conducted qualitatively using the individual critical incident technique, and 17 senior undergraduate nursing students enrolled in the Nursing OWCNTP were selected using a simple random sampling method. In the classroom setting, individual face-to-face interviews were conducted using the critical incident technique. Data were analyzed with inductive content analysis. The research found that students experience genuine caregiving in putting their experiences from the Track Program into practice with real patients in a clinical setting. Three main themes were identified: experiencing real patient care in a clinical setting, being a competent student, and being a novice student. The study found that nursing students enrolled in the OWCNTP could apply their theoretical knowledge to care for real patients in clinical settings. Therefore, it is recommended that these programs be integrated into nursing curricula.

Precision in Practice: The Critical Role of Mesh and Procedure Type Specification in Urogynecological Surgeries and Research

Recently, the debate surrounding the use of mesh in urogynecological procedures has intensified, leading to FDA warnings and heightened safety concerns. This clinical opinion emphasizes the vital need to specify mesh types in these procedures, drawing attention to the risk profiles and clinical outcomes associated with various meshes and the procedures that utilize them. A significant issue identified in contemporary literature is the tendency to group diverse mesh types under the same umbrella, disregarding their unique characteristics and applications. We describe the range of mesh types, their application routes, and associated complications, highlighting the risks of this nonspecific approach to patient safety and informed decision making. We critically examine the generalization of mesh terminology in clinical and research dialogues. Concluding with specific recommendations for health care providers and researchers, the paper advocates for a more nuanced understanding and communication in the field, ultimately aiming to improve patient care and safety in urogynecological practice.

Physician-nurse collaboration in the relationship between professional autonomy and practice behaviors.

Nurses and physicians are key members of healthcare teams. While physicians are responsible for the diagnosis and treatment of patients, nurses are part of the treatment and the primary practitioners of patient care. Nurses' professional autonomy, collaboration with physicians, and practice behaviors in treatment and patient care practices are interrelated. In the present study, we examined the mediating effect of physician-nurse collaboration on the relationship between nurses' practice behaviors and their professional autonomy. The present study utilized a cross-sectional survey design following quantitative methods. This study was conducted in the Istanbul Province of Turkiye from September to October 2022. The sampling method used was a convenience sampling strategy to provide easier access to participants when selecting nurses from different health institutions. The mean age of the 295 nurses was 31.23 years, with ages ranging from 21 to 59years. The data analysis was conducted using IBM's SPSS 24.0 software package and the Process Macro 4.0 plug-in. Research ethics approval was obtained from the researcher's university. Physician-nurse collaboration is positively associated with practice behaviors and professional autonomy. Nurses' professional autonomy in practice behaviors through physician-nurse collaboration is significant (95% CI [0.043, 0.135]). Our results revealed the relationships among physician‒nurse collaboration, professional autonomy, and practice behaviors among nurses. Our results provide evidence on the underlying factors of nurses' practice behaviors in patient care and guide the development of an intervention program to enhance this collaboration. Hospital managers can contribute to a collaborative physician‒nurse working environment.

Human Resource Management in the Healthcare Industry: An Analysis of the Connection Between Patient Care and Buddhist Practice

Since its inception, Buddhism and medicine have been closely associated, with each having a unique focus on reducing and averting human suffering. Despite the well-established connection between Buddhism and healthcare, there is still a dearth of Buddhist literature that can help healthcare professionals in both their personal and professional lives. Examples of the Buddha as a doctor, the Dharma as a treatment, and laypeople in general as patients can all be found in the sutras. Illness is strongly correlated with an individual's social, cultural, environmental, mental, and physical well-being. It is insufficient to approach medicine by focusing only on symptom elimination; It is crucial to address the psychosocial components of sickness as well as its psychological causes and treatments. All three components must be in harmony for holistic treatment to be provided, and Buddhist philosophy offers medical professionals insight. The medical ethical values of non-malice, compassion, justice, and autonomy are inevitably followed by health care practitioners who get ethical guidance from Buddhist medicine.

Oral care practices for patients in intensive care unit: A systematic review.

To critically analyse and discuss oral hygiene protocols in the hospital environment in patients admitted to the ICU, through a systematic review of the literature. The electronic search was performed on Pubmed, Cochrane, Web of Science and Google Scholar databases. The indexing keywords according to the PRISMA protocol were: 'hospital dentistry', 'oral health', 'oral care' and 'intensive care unit'. The initial search resulted in a total of 2671 articles. Pre-selection based on titles led to the exclusion of 2510 articles and the remaining 36 were selected for abstract reading. After analysing the eligibility of the articles, eight studies were included in the review and submitted to qualitative analysis. It can be concluded that cleaning with a soft bristle brush, use of chlorhexidine and lip moisturizing are methods commonly used in dental care actions in patients hospitalized in intensive care units.

Patient-initiated follow-up for high-risk cutaneous squamous cell carcinoma: how we do it and 2 years ofoutcome data.

For patients with high-risk cutaneous squamous cell carcinomas (cSCCs), current guidance suggests we should offer post-treatment follow-up appointments at regular intervals for 24 months. Is this to improve prognosis, provide psychological support or find the next cancer? Recent data confirm that recurrence and metastasis are rarer events, and that perhaps these intense follow-up schedules do not really lead to improved health outcomes. To question whether current follow-up practices are truly needed by introducing an option of patient-initiated follow-up (PIFU). We enrolled 476 patients with cSCC (January 2020-January 2023) who fulfilled the definition of high-risk cSCC based on guidelines in use at the time. Of the total, 59 did not fulful the inclusion criteria and were excluded; 250 (52.5%) did not recontact us during the 2-year period, with no clinical record of complications or recurrences; and 167 (35.1%) utilized the PIFU pathway, of which 119 patients required only one face-to-face appointment. Seven patients (1.5%) developed metastatic disease, 11 (2.3%) developed recurrence and 68 (14.3%) developed cSCC at another site. All lesions were identified by the patient via PIFU. We saved 1250 follow-up appointments from those who did not contact us (n = 250), financially equating to £181 462.50. Our data imply that PIFU can be considered safe alternative practice for patients with cSCC. Patients independently identified the need for review without scheduled follow-up, making these appointments available to other patient cohorts. Although follow-up appointments may provide mental health support, they can be inconvenient and not the ideal use of our healthcare resources. Our findings support a call for revision of existing skin cancer health policies to cope with and subsequently improve our practices for better patient care.

Croatian consultancy practices: a nurse’s experience report

INTRODUCTION: The article analyses the professional path of a nurse consultant. Nursing consulting is an expanding and stimulating profession with advanced practice roles and responsibilities. It emphasizes the nurse consultancy practice created through persistent effort, challenges, successes, and personal growth. Engaging in partnerships with healthcare organizations to enhance patient care, optimize workflows, and address challenges within the healthcare system. OBJECTIVE: To report on a nurse’s work experience as a nursing consultancy practice in Croatia's healthcare system. METHODOLOGY: The methodology utilizes descriptive, qualitative, and narrative approaches, with a specific focus on personal experiences and reflections. This methodology aims to share the nurse's journey and the transformative impact of their work in the nursing field. The study emphasizes the significance of authenticity, tenacity, and ongoing learning in nursing management and the execution of nurse consultancy practice in Croatia. RESULTS: The author underscores the significance of embracing a fresh outlook on Croatia's nursing and healthcare systems, particularly workflow integration and a comprehensive perspective of organizational and management business concepts. It provides insights into the process of establishing new hospitals, encompassing expertise in general management as well as specialized abilities in leadership and healthcare management. It also explores the evolution of patient rights and advocates for increased empowerment of nurses in influencing healthcare policies and decision-making, utilizing business Intelligence data to guide the advancement of the field. CONCLUSION: In summary, the nurse is dedicated to transforming the nursing profession by implementing innovative ideas and procedures, focusing on changing patient care attitudes and practices. The narrative journey embarked upon in this has provided a profound understanding of the nurse's career, offering insights into their thoughts, struggles, attitudes, and triumphs, the process of growth, adaptation, and unwavering commitment to bringing about a positive impact in the field of the nursing profession.

Development and validation of a job aid: Tool to reduce infections in home-based stroke.

Stroke patients who are discharged from hospital because of limited access to rehabilitation facilities are cared for by lay caregivers who at times have limited knowledge of infection prevention and control (IPC). User-friendly educational interventions can help bridge this knowledge gap and enhance safe care of these persons. To describe the development and validation of educational interventions for home-based stroke patients. The validation process enhanced the reliability and validity of the job aid resulting in standardised quality patient care of stroke patients. Mutasa district, Manicaland province, Zimbabwe. The systematic six steps in quality intervention development guided the development of the job aid. Graphic designers assisted with development of diagrams and annotations. A purposively selected eight-member panel of IPC expert reviewers was invited to validate the job aid using a standardised validation tool. The panel agreed that the job aid's title, target group and media of instruction were adequately explained, and the background could be easily understood during practice. The content was approved with some modifications on the description of instructions to caregivers. Seven reviewers agreed that the materials used ensured understandability, acceptability, practicability and usability of the educational interventions by caregivers, and one reviewer was neutral in commenting effectiveness of the job aid. The developed job aid addressed knowledge barriers in IPC for caregivers, and the reviewers confirmed that the developed job aid was adequate for effective use by lay home-based caregivers.Contribution:Utilisation of this intervention standardises patient care practices.

Rescuing the profession we love: general practice training sector recommendations for improving the attractiveness of general practice training. A qualitative analysis.

To investigate the views of the general practice training sector about responding to recruitment challenges, with the aim of identifying effective initiatives and other solutions. Qualitative study; focus group discussion of recommendations from a medical educator workshop. An initial online appreciative enquiry workshop for medical educators followed by focus group discussions by a broader selection of people involved in general practitioner training (Royal Australian College of General Practitioners fellows, supervisors, practice managers, medical educators, registrars). Key overarching themes and major recommendations for increasing recruitment derived from focus group responses to workshop recommendations, based on qualitative descriptive analysis. The 26 medical educators at the workshop made four major recommendations: increase the number of student and junior doctor clinical placements in general practice; increase exposure of students and junior doctors to general practitioner teachers and educators; improve general practitioner trainee pay and entitlements; and improve the integration of general practice and hospital patient care and professional relationships. Thirty-four semi-structured focus group participants broadly supported the recommendations, provided that supervisors and training practices were adequately compensated for the effects on workloads, income, and patient care. Two overarching themes infused participant responses: "rescuing the profession we love" (reflecting participants' passion for general practice and their sense of threat), and "no idea what general practitioners do" (perceptions of being misunderstood and misrepresented by hospital-based practitioners). Clinicians, educators, and policy makers should work together to increase the number of high quality, adequately supported student and junior doctor placements in general practice, improve intra-professional relationships, and trial new models of general practitioner trainee payment and conditions.

Benchmarking palliative care practices in neurooncology: a german perspective

PurposeTo benchmark palliative care practices in neurooncology centers across Germany, evaluating the variability in palliative care integration, timing, and involvement in tumor board discussions. This study aims to identify gaps in care and contribute to the discourse on optimal palliative care strategies.MethodsA survey targeting both German Cancer Society-certified and non-certified university neurooncology centers was conducted to explore palliative care frameworks and practices for neurooncological patients. The survey included questions on palliative care department availability, involvement in tumor boards, timing of palliative care integration, and use of standardized screening tools for assessing palliative burden and psycho-oncological distress.ResultsOf 57 centers contacted, 46 responded (81% response rate). Results indicate a dedicated palliative care department in 76.1% of centers, with palliative specialists participating in tumor board discussions at 34.8% of centers. Variability was noted in the initiation of palliative care, with early integration at the diagnosis stage in only 30.4% of centers. The survey highlighted a significant lack of standardized spiritual care assessments and minimal use of advanced care planning. Discrepancies were observed in the documentation and treatment of palliative care symptoms and social complaints, underscoring the need for comprehensive care approaches.ConclusionThe study highlights a diverse landscape of palliative care provision within German neurooncology centers, underscoring the need for more standardized practices and early integration of palliative care. It suggests the necessity for standardized protocols and guidelines to enhance palliative care's quality and uniformity, ultimately improving patient-centered care in neurooncology.

Elevating Patient Care and Clinical Practice: A Deep Dive into ASA's Latest Subspecialties and Education Achievements

Elevating Patient Care and Clinical Practice: A Deep Dive into ASA's Latest Subspecialties and Education Achievements

Strategies that facilitate the delivery of exceptionally good patient care in general practice: a qualitative study with patients and primary care professionals

BackgroundIn recent years, proactive strengths-based approaches to improving quality of care have been advocated. The positive deviance approach seeks to identify and learn from those who perform exceptionally well. Central to this approach is the identification of the specific strategies, behaviours, tools and contextual strategies used by those positive deviants to perform exceptionally well. This study aimed to: identify and collate the specific strategies, behaviours, processes and tools used to support the delivery of exceptionally good care in general practice; and to abstract the identified strategies into an existing framework pertaining to excellence in general practice; the Identifying and Disseminating the Exceptional to Achieve Learning (IDEAL) framework.MethodsThis study comprised a secondary analysis of data collected during semi-structured interviews with 33 purposively sampled patients, general practitioners, practice nurses, and practice managers. Discussions explored the key factors and strategies that support the delivery of exceptional care across five levels of the primary care system; the patient, provider, team, practice, and external environment. For analysis, a summative content analysis approach was undertaken whereby data were inductively analysed and summated to identify the key strategies used to achieve the delivery of exceptionally good general practice care, which were subsequently abstracted as a new level of the IDEAL framework.ResultsIn total, 222 individual factors contributing to exceptional care delivery were collated and abstracted into the framework. These included specific behaviours (e.g., patients providing useful feedback and personal history to the provider), structures (e.g., using technology effectively to support care delivery (e.g., electronic referrals & prescriptions)), processes (e.g., being proactive in managing patient flow and investigating consistently delayed wait times), and contextual factors (e.g., valuing and respecting contributions of every team member).ConclusionThe addition of concrete and contextual strategies to the IDEAL framework has enhanced its practicality and usefulness for supporting improvement in general practices. Now, a multi-level systems approach is needed to embed these strategies and create an environment where excellence is supported. The refined framework should be developed into a learning tool to support teams in general practice to measure, reflect and improve care within their practice.