Professional Perspectives Research Articles

Continuity of medication information transfer and continuous medication supply during hospital-to-home transitions - nationwide surveys in hospital and community pharmacies after implementing new legal requirements in Germany

BackgroundWhile successful information transfer and seamless medication supply are fundamental to medication safety during hospital-to-home transitions, disruptions are frequently reported. In Germany, new legal requirements came into force in 2017, strengthening medication lists and discharge summaries as preferred means of information transfer. In addition to previous regulations – such as dispensing medication at discharge by hospital pharmacies – hospital physicians were now allowed to issue discharge prescriptions to be supplied by community pharmacies. The aim of this survey study was to gain first nationwide insights into how these requirements are implemented and how they impact the continuity of medication information transfer and continuous medication supply.MethodsTwo nationwide self-administered online surveys of all hospital and community pharmacies across Germany were developed and conducted from April 17th to June 30th, 2023.ResultsOverall, 31.0% (n = 111) of all German hospital pharmacies and 4.5% (n = 811) of all community pharmacies participated. The majority of those hospital pharmacies reported that patients who were discharged were typically provided with discharge summaries (89.2%), medication lists (59.5%) and if needed, discharge prescriptions (67.6%) and/or required medication (67.6%). About every second community pharmacy (49.0%) indicated that up to half of the recently discharged patients who came to their pharmacy typically presented medication lists. 34.0% of the community pharmacies stated that they typically received a discharge summary from recently discharged patients at least once per week. About three in four community pharmacies (73.3%) indicated that most discharge prescriptions were dispensed in time. However, one-third (31.0%) estimated that half and more of the patients experienced gaps in medication supply. Community pharmacies reported challenges with the legal requirements – such as patients´ poor comprehensibility of medication lists, medication discrepancies, unmet formal requirements of discharge prescriptions, and poor accessibility of hospital staff in case of queries. In comparison, hospital pharmacies named technical issues, time/personnel resources, and deficits in patient knowledge of medication as difficulties.ConclusionAccording to the pharmacies´ perceptions, it can be assumed that discontinuation in medication information transfer and lack of medication supply still occur today during hospital-to-home transitions, despite the new legal requirements. Further research is necessary to supplement these results by the perspectives of other healthcare professionals and patients in order to identify efficient strategies.

Opinions of Health Professionals about the Management of Vaginal Deliveries: A Qualitative Research

The research aimed to identify the opinions of health professionals working in the field of obstetrics about the management of vaginal deliveries. The research was carried out with 18 health professionals having active duties in vaginal deliveries at a state university hospital in western Turkey. The maximum variation sampling method, one of the purposive sampling methods, was used. The research data were collected through information form and structured information form. They were analyzed through the thematic analysis method. Ethic Approval was received. Three main themes were identified about the management of vaginal deliveries in this research. (I) opinions of midwives about the management of vaginal deliveries, (II) opinions of nurses about the management of vaginal deliveries and (III) opinions of doctors about the management of vaginal deliveries. The participants (especially midwives and doctors) stated that they overall viewed themselves as a significant activist in the responsibility for vaginal delivery, and midwives could carry out vaginal deliveries due to the workload and the fact that the pregnant women were followed up by midwives. Midwives and nurses emphasized that delivery was not only a medical action but also brought significant responsibilities requiring active care in pregnancy, delivery and the postpartum. The perspective of health professionals was mainly in the direction of the fact that all midwives, who had sufficient education and skills, could carry out vaginal deliveries independently. They agreed that the team who would carry out the delivery should be given continuous institutional training in terms of theory and practice. It is necessary that active studies should be planned on matter of the fact that especially the nurses and midwives in university hospitals could carry out their independent duties and increase their responsibilities for vaginal deliveries as a part of a team.

Facilitators and barriers to interprofessional collaboration among health professionals in primary healthcare centers in Qatar: a qualitative exploration using the “Gears” model

BackgroundThe number of patients seeking medical care is increasing, necessitating more access to primary healthcare services. As several of these patients usually present with complex medical conditions, the need for interprofessional collaboration (IPC) among health professionals in primary care is necessary. IPC is essential for facing the increasing and challenging healthcare demands. Therefore, the facilitators of and the barriers to IPC should be studied in the hope that the results will be used to promote such endeavors.ObjectivesThis study aimed to explore the perspectives of different health professionals regarding the facilitators of and the barriers to IPC in the primary healthcare settings in Qatar.MethodsA qualitative study using focus groups was conducted within the Primary Health Care Corporation (PHCC) in Qatar. Several health professionals were invited to participate in the focus groups. The focus groups were uniprofessional for general practitioners (GPs), nurses, and dentists, while they were interprofessional for the other health professionals. Focus groups were audio-recorded and transcribed verbatim and validated by the research team. The data were analyzed by deductive thematic analysis using the “Gears” Conceptual Model as a coding framework.ResultsFourteen focus groups were conducted involving 58 participants (including 17 GPs, 12 nurses, 15 pharmacists, 3 dentists, and 11 allied health professionals) working in PHCC in Qatar. The findings revealed a spectrum of factors influencing IPC, categorized into four main domains: Macro, Meso, Micro, and individual levels, with each accompanied by relevant barriers and facilitators. Key challenges identified included a lack of communication skills, insufficient professional competencies, and power imbalances, among others. To address these challenges, recommendations were made to implement dedicated training sessions on IPC, reduce hierarchical barriers among different health professionals, and enhance the effectiveness of existing systems. Conversely, it was emphasized that projects and campaigns focused on IPC, alongside the development of enhanced communication skills and the presence of supportive leadership, as essential for facilitating effective IPC in PHCCs.ConclusionThe interplay between the meso, macro, micro, and individual levels highlight the significance of a multifaceted approach to interventions, aiming to enhance the successes of IPC. While initiatives like interprofessional education training are underway, numerous challenges persist before achieving improved collaboration and more efficient integration of IPC in the PHCC setting.

Barriers to healthy transitions between nursing homes and emergency departments

This study identifies barriers to healthy transitions between nursing homes and emergency departments by exploring current practices in both primary care (out-of-hours primary care and nursing homes) and specialist healthcare (ambulance services and emergency departments) organizations from the perspectives of healthcare professionals. The objective is to highlight areas where improvements to these transitions are most needed. NH residents frequently use acute healthcare services. Many have complex healthcare needs, requiring coordination across multiple providers and different healthcare settings. Transitions theory by Afaf Meleis inspired this study and helped identify barriers to healthy transitions between nursing homes and emergency departments. Eighteen qualitative interviews were conducted with healthcare professionals from nursing homes, ambulance services, out-of-hours primary care, and emergency departments. Three themes were identified from the interviews: 1: staff burden, 2: discontinuity of care, and 3: transitions taking a toll on the well-being of residents. This study identifies critical areas needed to improve transitions between nursing homes and emergency departments. Many of the barriers to healthy transitions are systemic, suggesting that micro, meso, and macro-level efforts are needed.

"What will the caregiver do?" at home for stroke exercise using a wheelchair: qualitative research in multidisciplinary health professionals perspective

"What will the caregiver do?" at home for stroke exercise using a wheelchair: qualitative research in multidisciplinary health professionals perspective

Professional perspectives on facilitators and barriers for high quality provision of health, education and social care services to disabled children in England during the COVID-19 pandemic: a qualitative study

ObjectivesTo understand how health, education and social care services for disabled children changed during the COVID-19 pandemic, what did or did not work well and what the impacts of service...

The 6Ps of Preparing a Manuscript: Prior Preparation Prevents Potentially Poor Performance.

The process of writing a scientific document, whether it be a PhD thesis, a paper, review, chapter, book or even a book series, always begins with only one word. Why can writing a manuscript be so difficult to start? If there are sufficient data for the task, there is only one reason; vacillation. To address this serious and psychologically debilitating issue, this perspective will discuss the ethos of publishing and provide a solution for vacillation. The concept of sufficient novel data will be examined along with the criteria for identifying an appropriate home for a manuscript. The bare process of preparation will be described, which ultimately relies on discipline, routine, formatting and further discipline, with the ultimate goal being the production and quality control of a manuscript of the highest quality that you can achieve. The value of the secondary literature, namely reviews, chapters and books will be highlighted, specifically with regard to the building of a reputation and leaving a lasting legacy. The psychology of publishing, particularly dealing with success and failure will be covered, as this topic is often overlooked, and can have serious and deleterious mental health consequences. A balanced view of publication metrics will be given, showing that such factors are in some cases, purely a business strategy for publishing houses. Ideas to build one's career through networking, reviewing and being an ambassador for one's discipline are also given. As a former member of the Editorial Advisory Board of the Journal of Natural Products (2018-2022), an overview of the manuscript writing process from a personal and professional perspective is emphasized to encourage all to avoid the trials and tribulations of procrastination.

The impact of high-performance work practices on employee burnout experience in UK higher education: a professional services perspective

ABSTRACT Evidence demonstrates work intensity is on the rise and can lead to higher rates of burnout. The UK Higher Education professional services sector has been under-researched in terms of work intensity levels and experience of burnout. This research measured these levels and sought evidence of whether high-performance work practices (HPWPs) moderate the user’s level of burnout. Quantitative data were collected using a cross-sector survey and tested for correlation. The results evidenced a moderate, positive relationship between work intensity and burnout, and a strong, negative relationship between HPWPs and burnout. Drawing on the Job Demands – Resources model (Demerouti et. al. 2001), this research contributes to the understanding of the factors contributing to burnout in the UK Higher Education context. Practical implications include addressing the widespread culture of overwork and employing HPWP suites to moderate burnout. Suggestions for further research provide additional clarity.

Research priorities for medically not yet explained symptoms expressed by patients, carers, and healthcare professionals in the Netherlands following the James Lind Alliance priority setting partnership approach

ObjectiveExperiencing physical symptoms that are medically not yet explained (MNYES) is associated with considerable burden in daily life. Research priorities in this area have been primarily investigator-driven. The present study identifies the top 10 research priorities, incorporating the views of patients, carers and healthcare professionals. MethodsThis study used the Priority Setting Partnership approach in collaboration with the James Lind Alliance (JLA). The priority setting approach combines survey-based data from patients with a specific disorder/condition and relevant stakeholders (i.e., caregivers and healthcare professionals) with input from group meetings and a final priority setting consensus meeting. There were three consecutive phases: (1) online survey with an open-ended question to collect topics for future scientific research (N = 345 participants); (2) an online survey among stakeholders to prioritise the research questions generated in Phase 1 (N = 400); and (3) a final multi-stakeholder consensus meeting, held over two half-days to determine the final top 10 research priorities for the Netherlands (day 1 N = 25, day 2 N = 24). ResultsPhase 1 resulted in 572 topics, which were reduced to 37 summary research questions. Phase 2 resulted in 18 research priorities, that were ranked and the top 10 priorities were established during the final consensus meeting. The top 10 research priorities included three main themes: optimising efficient diagnosis and treatment, aetiology and prevention, and coping with MNYES. ConclusionThe top 10 priorities provide insight into what is most important for future research into MNYES from the perspective of patients, carers and healthcare professionals.

Diffusion of Innovation Theory Adaptation in Genomic-Based Product Marketing Strategy

With the rise of preventative healthcare needs after the COVID-19 pandemic, tanyaDNA, a genomics company in Indonesia, seeks to introduce Lifestyle and Pharmacogenomic Testing. This study explores using Diffusion of Innovation Theory to create a targeted marketing strategy for this new service. There's a lack of awareness and affordability concerns surrounding the test, along with a knowledge gap between the company, healthcare professionals, and the target market. The research aims to assess the theory's applicability, bridge these understanding gaps, and promote successful integration of the test into Indonesian healthcare. This can inform marketing strategies for other genomics companies looking to expand beyond COVID-19 testing. The study focuses on the JABODETABEK area of Indonesia and utilizes surveys and interviews to gather data. The findings can help bridge the gap between product creators and target markets, especially regarding the perspectives of key healthcare professionals.

Development and early implementation of telemonitoring of complicated pregnancies – A qualitative study with the perspectives of health professionals

BackgroundTelemonitoring may offer promising opportunities in health care. In obstetric health care, there is a need to expand and improve digitalization. Nevertheless, there is limited knowledge based on healthcare professionals' perspectives regarding the use of telemedicine and remote cardiotocography during pregnancy, as well as its implementation. AimTo explore the perspectives of health-care professionals who manage telemonitoring of complicated pregnancies. Design and settingA qualitative interview study undertaken in a hospital with a tertiary obstetric unit in Northen Denmark. MethodsBased on a purposive sample strategy, 11 semi-structured interviews of health-care professionals involved in the management of telemonitoring in women with complicated pregnancies were conducted and analyzed using a reflexive thematic analytical approach. FindingsThe findings are assembled into two main themes. The experience of relevance to own practice: included the embedded potentials in telemonitoring providing women-centred care, but also challenges related to the implementation of a new technology. Experience of challenges and potential in day-to-day operation: included frustrations regarding the technological devices and software, working experiences increasing confidence in telemonitoring, and perspectives on the required interdependence across departments. ConclusionThis study adds important knowledge to support awareness and reflection on how challenges impact the successful implementation of telemonitoring in obstetric and midwifery care. This includes knowledge of important processes and resources to ensure ongoing implementation and evaluation. Implementation strategies and collaborations to support a multiple-level system change, such as an interdisciplinary team, seem crucial to minimize challenges, build shared visions, and engage staff.

Disciplinary digital capabilities of professionals

This paper is concerned with the digital practices of professionals, and the ways in which educators can support higher education (HE) students with successfully transitioning into professional life by developing relevant digital capabilities according to their disciplines. Digital capabilities have received significant attention in recent years, with various attempts made to develop digital frameworks to support curriculum design in HE. However, few studies have articulated these generic capabilities in terms of specific disciplines. This paper addresses the gap of disciplinary conceptualisations of digital capabilities by exploring how they are planned in HE curricula in two professional disciplines, engineering and management. Originality of the study is achieved in part through a conceptual framework that weaves together Shulman’s notion of signature pedagogies with JISC’s Digital Capability Framework (DigiCap). The study employed a multiple-case study methodology with each discipline as a case, and four undergraduate/postgraduate modules as the units of analysis, drawing on documentary sources, and academic, professional and student perspectives via interviews and focus groups. The research design section presents a practical manifestation of this conceptual framework in the form interview questions, which is one main outcome of this study. The study offers insight into the digital capabilities in engineering and management education, as well as the digital practices of engineers and managers. Findings report on which digital capability elements are prioritised, and how, in the two professions, followed by a discussion of their most distinct, 'signature digital capabilities'. These indicate that the development of digital capabilities is aligned with the respective discipline’s signature pedagogies. In engineering, digital problem-solving and collaboration/communication, followed by data and information literacy, appear to be most prominent. In management, data and information literacy overlap with problem-solving, and, together with digital content communication, form its prominent digital capabilities. The study also identifies management’s overarching signature digital capability. The paper argues that simply just using a descriptive, typological framework (e.g. DigiCap) is not sufficient to identify signature digital capabilities of a subject without tending to their disciplinary aspects. It is the combination of a typological digital capability framework through the lens of signature pedagogies, which can be effective in identifying disciplinary digital capabilities.

Culturally Safe Care Barriers and Facilitators in Organ Transplantation and Donation According to First Nations and Health Professionals in Quebec, Canada.

Introduction: First Nations are most at risk of developing end-stage kidney disease. Kidney transplantation is the best treatment option for these patients; however, First Nations donors are underrepresented. The aim of this study was to describe and understand barriers and facilitators of culturally safe organ transplantation and donation from the perspective of First Nations and Health Professionals in the Province of Quebec, Canada. Methods/Approach: This was a qualitative descriptive study using the decolonizing Two-Eyed Seeing approach. The sample consisted of First Nations people and health professionals living in Quebec, Canada, who have had an experience of organ transplantation or donation. Semi-structured interviews were conducted between May and September 2021 with 11 people, including 5 healthcare professionals and 6 First Nations people. Findings: This study enrolled 11 participants. Several individual and contextual factors influencing culturally safe organ transplantation and donation among First Nations people were identified: language barrier, impacts of relocation, lack of knowledge about transplantation, mistrust of the healthcare system, family support and accompaniment, and transplant testimonials. Discussion: This study identified several avenues for reinforcing culturally safe transplantation and donation among First Nations, including the presence of a companion in medical consultations, focusing on access to culturally safe accommodation and sharing transplant testimonials. Further work in partnership with First Nations is needed to improve access to culturally safe organ transplantation.

Positive perspectives of primary care professionals towards patients in complex and challenging social situations in Japan: An educational opportunity.

Although primary care professionals often encounter difficulties when attending to patients in complex and challenging social situations (CCSS), little is known about how professionals cultivate an optimistic approach to caring for patients in CCSS. This study aims to recruit professionals who exhibit a passion for seeing patients in CCSS, to gain insights into their positive attitude. We conducted a qualitative study in Japan of 30 primary care professionals: 15 physicians and 15 non-physician professionals (nurses, medical social workers and medical clerks). We performed online in-depth interviews and employed a thematic analysis utilising the framework approach to identify how the participants felt a passion for seeing patients in CCSS. Two themes emerged about the passion: (i) the joy derived from interacting with patients and (ii) the joy derived from professional growth or development. Participants expressed curiosity about their patients, found happiness in the journey with them and established irreplaceable relationships. Concurrently, participants noted professional growth as expert generalists, and their team developed collaboration and competency through accumulating experience and learning. These two domains of joy were intricately interconnected. In addition, several factors related to developing, maintaining and spreading the positive attitude were identified. This study described the positive attitude of primary care professionals towards engaging with patients in CCSS. Despite the inherent challenges, these professionals demonstrated vibrancy and pleasure in their interactions with patients and their professional development. Workplace culture including team-based support and continuous learning is important in fostering and maintaining such an attitude.

Navigating the shadows: medical professionals' values and perspectives on end-of-life care within pediatric intensive care units in Croatia.

This study explores healthcare professionals' perspectives on end-of-life care in pediatric intensive care units (ICUs) in Croatia, aiming to illuminate their experiences with such practices, underlying attitudes, and major decision-making considerations. Amid the high variability, complexity, and emotional intensity of pediatric end-of-life decisions and practices, understanding these perspectives is crucial for improving care and policies. The study utilized a cross-sectional survey intended for physicians and nurses across all pediatric ICUs in Croatia. It included healthcare professionals from six neonatal and four pediatric ICUs in total. As the data from neonatal and pediatric ICUs were examined jointly, the term pediatric ICU was used to denominate both types of ICUs. A statistical analysis was performed using Python and JASP, focusing on professional roles, professional experience, and regional differences. The study included a total of 103 participants (with an overall response rate-in relation to the whole target population-of 48% for physicians and 29% for nurses). The survey revealed diverse attitudes toward and experiences with various aspects of end-of-life care, with a significant portion of healthcare professionals indicating infrequent involvement in life-sustaining treatment (LST) limitation discussions and decisions, as well as somewhat ambiguous attitudes regarding such practices. Notably, discrepancies emerged between different professional roles and, in particular, regions, underscoring the high variability of LST limitation-related procedures. The findings highlight a pressing need for more straightforward guidelines, legal frameworks, support mechanisms, and communication strategies to navigate the complex terrain of rather burdensome end-of-life pediatric care, which is intrinsically loaded with profound ethical quandaries.

Commentary: Perspectives of Early Career Professionals on Enhancing Cultural Responsiveness in Educational Measurement

Commentary: Perspectives of Early Career Professionals on Enhancing Cultural Responsiveness in Educational Measurement

Emerging Voices: Amplifying the perspectives of students and new professionals

Emerging Voices: Amplifying the perspectives of students and new professionals

Latent profile analysis of nurses' moral courage: a professional values perspective.

Nurses' moral courage (NMC) enhances care quality and patient safety. Nurses' professional values promote ethical adherence, moral obligation fulfillment, and compliance to prevent ethical violations. It is necessary to explore the current status and influencing factors of moral courage from the perspective of professional values. To investigate the current situation of nurses' moral courage, analyze the latent profiles of nurses' moral courage, and explore the influencing factors from the perspective of professional values. A cross-sectional design was employed. Data were collected through convenient sampling at a tertiary hospital during May 2023 in Wuhan, Hubei province, China. A self-designed web-based questionnaire consisting of demographic characteristics, the Chinese Nurses' Professional Values Scale-Revised Version (NPVS-R-CV) and the Nurses' Moral Courage Scale (NMCS) were used for the cross-sectional survey. Latent profile analysis was conducted using the results of 3 explicit indexes of NMCS, and multivariate logistic regression was used to analyze the influencing factors of NMC. Research ethics approval (with the code of TJ- IRB 20220543) was obtained from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. This study included 966 nurses, predominantly female and under 30years old, with 91.10% holding a bachelor's degree. Latent profile analysis identified three moral courage profiles: low-level (31.5%), medium-level (47.2%), and high-level (21.3%). Multivariate logistic regression analysis showed significant positive correlations between professional values and moral courage, with head nurses being significantly more likely to exhibit high moral courage (OR = 3.586, p = 0.013). The moral courage of nurses can be classified into 3 subgroups. Nurses' professional values positively correlate with moral courage, with head nurses showing significantly higher levels of moral courage. Strengthening professional values through training can enhance ethical behavior in nursing, potentially improving patient care and safety.

Knowledge, Beliefs, and Experiences With Mental Health Services and Help-Seeking in People With Aphasia and Care Partners.

Supporting psychological well-being in persons with aphasia (PWA) can improve social and health outcomes; however, PWA and their care partners (CPs) are often not receiving mental health support. Previous research explores this from the perspective of health care professionals. The aim of this study was to examine knowledge, beliefs, and experiences related to mental health services directly from PWA and CPs. The study included 11 PWA and 11 CPs. Participants completed a guided survey (virtual) with opportunities for elaboration related to the knowledge, beliefs, and experiences of mental health. There was variability in personal preferences for referrals, types of coping strategies, and confidants for general thoughts and feelings and those specific to aphasia. PWA identified health care professionals as people to share thoughts and feelings, whereas CPs chose family and friends more often. Both CPs and PWA reported communication difficulty and finding a counselor as "sometimes" preventing access to services but cited fear and trust as "always" preventing access. Knowledge, beliefs, and experience with help-seeking and mental health services are personal and variable. Assessing barriers unique to living with aphasia, such as communication challenges and locating a suitable counselor, must also be considered within more complex and personal barriers of fear and trust that are consistently reported in the general public. Health professionals across the continuum of aphasia care need to understand the communication challenges of living with aphasia in tandem with understanding individual differences to personalize approaches to mental health services and help-seeking.

2304 Models of care and the role of clinical pharmacists in UK primary care for older people: findings from a scoping review

Abstract Introduction Pharmacists have traditionally worked in primary care, in the community, and with GPs. However, the role of the clinical pharmacist in primary care is evolving and there are plans to employ more clinical pharmacists in the NHS. With an ageing UK population, there is an increase in the number of people living with multiple long-term conditions, accompanied by polypharmacy, posing numerous challenges to healthcare systems. This review investigates the evidence about the varied roles and services delivered by clinical pharmacists in primary care, capturing the perspectives of health and care professionals, older adults, and their carers. Method Our scoping review followed the framework for scoping reviews in accordance with the Joanna Briggs Institute (JBI) methodology. A broad search was conducted in 2023 in CINAHL, Cochrane, Medline, SCOPUS, and Web of Science. We included articles that explored the landscape of clinical pharmacy services for older people in the UK, focusing on roles and services delivered, perceptions, and experiences. Results A total of 23 articles was included. These shed light on the multifaceted responsibilities of clinical pharmacists for older people. Stakeholder perspectives, including healthcare professionals and care home staff, emphasise the positive outcomes of clinical pharmacist involvement, from reducing other practitioners’ workloads to improving patient safety. However, communication gaps among the primary care team and those living with dementia, concerns about competence, and the need for clear role definitions of clinical pharmacists emerge as challenges. Conclusions and implications The review enhances our understanding of the clinical pharmacist service in the UK and identifies gaps in research evidence, emphasising the need for empirical studies on the experiences of older people with cognitive impairment and those from minority ethnic backgrounds. The findings can be used for policymaking, workforce planning, and healthcare provision to improve the services for older people in the UK.