Survey Of Healthcare Professionals Research Articles

Experiences of coordinated care for people in the UK affected by rare diseases: cross-sectional survey of patients, carers, and healthcare professionals

BackgroundPoorly coordinated care can have major impacts on patients and families affected by rare conditions, with negative physical health, psychosocial and financial consequences. This study aimed to understand how care is coordinated for rare diseases in the United Kingdom.MethodsWe undertook a national survey in the UK involving 760 adults affected by rare diseases, 446 parents/carers of people affected by rare diseases, and 251 healthcare professionals who care for people affected by rare diseases.ResultsFindings suggested that a wide range of patients, parents and carers do not have coordinated care. For example, few participants reported having a care coordinator (12% patients, 14% parents/carers), attending a specialist centre (32% patients, 33% parents/carers) or having a care plan (10% patients, 44% parents/carers). A very small number of patients (2%) and parents/carers (5%) had access to all three—a care coordinator, specialist centre and care plan. Fifty four percent of patients and 33% of parents/carers reported access to none of these. On the other hand, a higher proportion of healthcare professionals reported that families with rare conditions had access to care coordinators (35%), specialist centres (60%) and care plans (40%).ConclusionsCare for families with rare conditions is generally not well coordinated in the UK, with findings indicating limited access to care coordinators, specialist centres and care plans. Better understanding of these issues can inform how care coordination might be improved and embrace the needs and preferences of patients and families affected by rare conditions.

Quality of health care and interdisciplinary collaboration from the perspective of employees and patients

Abstract Introduction. Cooperation in an interdisciplinary team is an important aspect of ensuring the quality and safety of patient care, although the interaction of individuals from different disciplines in the clinical environment can also be hampered by inadequate communication. Aim. This study attempts to fill the research gap and identify professionals’ perceptions of interdisciplinary collaboration and quality measures, the impact of interdisciplinary collaboration on the quality of care in a general hospital and clarify the perspective of patients and healthcare professionals. Material and methods. The case study was conducted using a survey of healthcare professionals (N = 150) and a qualitative approach by interviewing healthcare professionals (N = 47) and patients (N = 20). Results and conclusions. The results of the survey show that the nurses rated all the criteria of interdisciplinary cooperation and individual quality criteria the highest, and the quality of care in general the worst, as they were not satisfied with the implementation due to the lack of staff. The exchange of information did not affect the quality of care because organizational and national authorities did not sufficiently consider the views of staff. In in-depth interviews, patients rate teamwork as poor because they do not get enough explanation and do not feel treated as equal members of the medical team. In in-depth interviews, patients and healthcare professionals are aware of the lack of teamwork among themselves, as well as of the quality of care due to staff shortages in general and especially during the pandemic.

Knowledge, Perception and Challenges of Implementing Nutrition Screening: A Survey of Healthcare Professionals

BACKGROUND: Preoperative malnutrition is common in hospital settings; however, one major problem is the short practices to screen surgical patients as a part of nutrition care management to address the issue of malnutrition. OBJECTIVES: The aim of this study is to assess the knowledge, perceptions, and challenges of Healthcare Professionals (HCPs) to implement NS in pre-operative patients. METHODS: A cross-sectional survey was undertaken between April and May 2023. RESULTS: A total of 103 respondents participated in this survey. Almost 75% of HCPs acknowledged the importance of managing malnutrition in preoperative patients; however, there is a lack of implementation of NS (32.4%) and a need for training for HCPs (74.5%), which relates to fewer patients being referred to a dietitian for better nutrition care. All HCPs have a positive perception (85.4%) of the importance of preoperative NS and concur that challenges faced to execute NS accordingly beforehand are the barrier (52.3%). CONCLUSIONS: The present study suggests that HCPs are aware of early identification of malnutrition but lack implementation of NS. There is a remarkable need for the establishment of a standardised nutrition care pathway for better nutrition intervention in pre-operative patients.

Nutrition Care after Hospital Discharge in Singapore: Evidence-Based Best-Practice Recommendations.

The nutritional status of hospitalised patients is often at risk or compromised and predisposed to further deterioration after discharge, leading to poor clinical outcomes, high healthcare costs, and poor quality of life. This paper aims to provide evidence-based best-practice recommendations to address this, supported by a national survey of healthcare professionals in Singapore and reviewed by a multidisciplinary expert panel under the Sarcopenia Interest Group of Society of Parenteral and Enteral Nutrition Singapore (SingSPEN). We advocate screening all patients with a validated tool which includes a disease activity/burden component, an easily accessible dietitian referral pathway for patients at risk of malnutrition, and an individualised nutrition care plan formulated and delivered using a multidisciplinary team approach for patients at risk or with malnutrition. A comprehensive team would include not only dietitians but also physicians, nurses, physiotherapists, speech therapists, and medical social workers working together towards a common goal. Information on why nutrition is important for good health and how it can be achieved should also be provided to all patients and their caregivers before and after hospital discharge. With the above recommendations, we seek to improve upon the current nutrition care processes at discharge for healthcare institutions in Singapore.

Preconception and Pregnancy Nutrition Support for Women with a History of Bariatric Surgery: A Mixed-Methods Survey of Healthcare Professionals in the UK.

Preconception bariatric surgery improves obesity-related maternal pregnancy complications but may reduce the absorption of nutrients required for healthy fetal growth and development. Women who receive preconception nutritional support after bariatric surgery are less likely to have adverse pregnancy outcomes. This study aimed to investigate the provision of preconception and pregnancy-specific nutritional support for women having bariatric surgery in the UK. A mixed-methods survey was distributed to healthcare professionals working in obesity or maternity services between December 2018 and October 2019. We collected both quantitative and qualitative data which were analysed using a mixed-methods approach. We received 135 responses from online (n = 99) and postal (n = 36) questionnaires. Only 45% of participants reported being 'very familiar' with the preconception/pregnancy nutritional needs of this population. Barriers to providing nutritional support included: a lack of resources and time; poor communication both across services and with women; not having contact with women preconception; and a lack of information and guidance. Respondents felt that dietitians have the expertise in nutrition necessary to provide support; however, GPs and midwives have the most frequent patient access post-surgery, both before and during pregnancy. Optimal preconception and pregnancy-related nutritional support requires multidisciplinary care pre- and post-surgery, and healthcare professionals require training and guidance to inform practice.

Knowledge and attitudes towards medicinal cannabis and complementary and integrative medicine (CIM): a survey of healthcare professionals working in a cancer hospital in Australia

PurposeWe investigated attitudes and practices of healthcare professionals (HCPs) to medicinal cannabis (MC) and complementary and integrative medicine (CIM), including individual therapies, such as acupuncture, massage, herbs, dietary supplements, nutrition and exercise. We explored whether healthcare occupation influenced attitudes to CIM and MC; referral pathways for advice on CIM; and interest in a pharmacy service to evaluate herbs and supplements.MethodsCross-sectional survey. All clinical staff at a comprehensive cancer hospital were invited to complete an anonymous questionnaire about CIM and MC. We used descriptive analysis to describe the respondent’s knowledge and attitudes, and Fisher’s exact test to test for differences by occupation, length of time at the hospital and age.ResultsMost of the 116 HCPs respondents supported integrating CIM into cancer care (94.8%) and wanted to learn more (90%) and to understand benefits and contraindications. Most respondents believed that CIM (87.9%) could benefit patients with cancer, and MC could benefit those with advanced cancer (49–51%). Whilst just over half (52.6%) felt confident discussing CIM with patients, only 10% felt they had sufficient knowledge to discuss MC. Most felt they did not have sufficient knowledge to specifically discuss mind and body practices (63.8%) or herbs and supplements (79%). HCPs (63%) would be more inclined to allow use of herbs and supplements with cancer treatment if a pharmacy service was available to evaluate interactions. Occupation, length of time at hospital and age influenced confidence and knowledge about CIM.ConclusionsThe integration of evidence-based CIM and MC into cancer care is hampered by a lack of knowledge of benefits and contraindications, and gaps in education. Effective and safe integration may require targeted development of services such as pharmacy to evaluate the safety of herbs and supplements, and inclusion of cancer specialists who have received training in individual CIM therapies and MC.

S1168 Assessing Bowel Urgency in Clinical Practice: Results From a Healthcare Professional Survey

S1168 Assessing Bowel Urgency in Clinical Practice: Results From a Healthcare Professional Survey

Quality of Life and Home Parenteral Nutrition: A Survey of Healthcare Professionals’ Knowledge, Practice and Opinions

Quality of Life and Home Parenteral Nutrition: A Survey of Healthcare Professionals’ Knowledge, Practice and Opinions

291 Improving the collateral history for older people admitted to hospital: the 6 Cs

Abstract Background Despite its central role in diagnostic formulation in unwell older adults, particularly those with memory problems, little scrutiny has been applied to Collateral History (CH) taking from how/when it should be performed, what information should be gathered and how it should be assimilated. This quality improvement project aims to address this by improving processes around collateral history taking for older patients. Methods The objectives of this project were to: (i) Establish information that should be included in the CH, (ii) Assess if this information is currently being collected and (iii) Use this to inform a proforma to assist with CH taking. Health-Care Professionals (HCPs) involved in the care of older people ranked information from CH in terms of relevance/importance (online survey). An audit was performed on a sample of consecutive patients aged ≥65 years admitted under the geriatric medicine service from 01/02/2023–17/02/2023, to assess compliance with and content of collateral histories against our HCP survey. Results 41 HCPs (13/41 (32%) medical, 6/41 (15%) nurse specialists, 15/41 (37%) physiotherapists/occupational therapists, 7/41 (17%) medical social workers) were surveyed. They ranked baseline and recent changes in cognition, function and mobility as key features of the CH. CHs were completed in 70% (35/50) of admissions (n = 50, mean 83 years, 42% documented cognitive impairment). Baseline cognition and function were documented in less than half of collateral histories, change in cognition in 18/35 (51%); change in function in 10/35 (29%). Baseline mobility was documented in 20/35 (57%); change in mobility in 9/35 (26%). Findings then informed an electronic patient record (EPR) proforma: ‘The 6 Cs of the Collateral History’ (Consent, Contact, Cognition, Change (Function/Mobility), Communication, Conclusion). Conclusion Compliance with, and content of, CHs vary widely. This QI project aims to address this by using an EPR proforma, co-designed by clinicians involved in the care of older people, to prompt/structure CH taking.

P-455 Survey of multiple myeloma (MM) patients and healthcare professionals (HCPs) on the relevance of existing health quality-of-life (QoL) questionnaires (QoLQ) to real-world QoL issues of MM patients

P-455 Survey of multiple myeloma (MM) patients and healthcare professionals (HCPs) on the relevance of existing health quality-of-life (QoL) questionnaires (QoLQ) to real-world QoL issues of MM patients

Impact of pharmacist-led admission medication reconciliation on patient outcomes in a large health system

Objective Performing accurate medication history and reconciliation is recognized to reduce medication discrepancies and errors resulting in improved patient safety. This quality improvement project retrospectively evaluated the impact of a newly implemented pharmacy-led admission medication reconciliation program for several hospitals. Methods In 2020, a pharmacy-led admission medication reconciliation program was implemented in 16 hospitals across a large health system. The program targeted high-risk, complex inpatients admitted through the emergency department and directly to the hospital. Medication history technicians captured the best possible medication list and medication reconciliation pharmacists reviewed the list, collaborating with providers to complete reconciliation, and intervening to optimize drug therapy. A retrospective, pre-post analysis was performed comparing the preimplementation time period of June to November 2019 to the postimplementation time period of June to November 2020. Outcomes evaluated included pharmacy staff productivity, adverse drug events (ADEs), complications, and healthcare professional satisfaction. Results A total of 311,473 patients were admitted to the 16 hospitals during the pre- and postimplementation time periods. During the six-month postimplementation period, nearly 80,000 medication histories and reconciliations were completed, with 39.9% of those histories requiring medication clarification. Both the ADE rate and complication rate decreased significantly after program implementation, 12% decrease ( p < 0.017) and 14% decrease ( p < 0.001), respectively. Healthcare professional survey results from nurse, physician, and pharmacist respondents indicated a statistically significant improvement in satisfaction. Conclusion After implementation of pharmacy-led admission medication reconciliation, patient ADEs and complications decreased during hospitalization, and physician, nurse, and pharmacist satisfaction significantly improved.

A Survey of Pharmacists and Other Healthcare Professionals in Vietnam: Factors Influencing Knowledge and Attitudes Toward Reporting Adverse Drug Reactions.

Knowledge and attitudes of healthcare professionals are significant factors that affect the reporting of adverse drug reactions (ADRs). No previous research has examined the predictors of knowledge and attitudes toward ADR reporting in Vietnam. The aim of this study was to examine the factors (ie, demographic and job-related characteristics) associated with inadequate knowledge and negative attitudes toward ADR reporting in a Vietnamese public hospital. A survey recruited a cross-sectional sample of 511 healthcare professionals (with a response rate of 92.9%) at a public hospital in Vinh Long province, Vietnam, from December 2022 to February 2023, using a self-administered questionnaire. Factors related to knowledge and attitudes toward ADR reporting were identified using univariate and multivariate logistic regression. Pharmacists had significantly lower knowledge scores (mean = 5.86) than medical practitioners (7.24) and nurses (6.72). Additionally, pharmacists' attitudes scored significantly lower (34.61) than those of medical practitioners (37.21) and nurses (36.86). Multivariate logistic regression showed that educational level, healthcare profession, monthly on-call shifts, and number of direct patient interactions were factors associated with a lower level of knowledge regarding ADR reporting. Additionally, age group and healthcare profession were identified as factors associated with negative attitudes toward ADR reporting among healthcare workers. Our study identified several factors associated with lower levels of knowledge and negative attitudes toward ADR reporting among healthcare workers in Vietnam. These findings highlight the need for targeted interventions and education programs to improve healthcare workers' knowledge and attitudes toward ADR reporting.

Knowledge, attitudes, and practices of healthcare professionals on oral care of pregnant women in Brunei Darussalam

ObjectiveTo examine nationwide the knowledge, attitudes, and practices of healthcare professionals on oral/dental care of pregnant women in Brunei Darussalam.Materials and methodsA descriptive cross-sectional study conducted using an online survey of eligible healthcare professionals in all Government Maternal and Child Health Care Clinics, Dental Clinics and Obstetrics and Gynecological Clinics in four hospitals covering the whole of Brunei Darussalam. Participants were given seven days to complete the survey. Sub-group analysis using Chi-square test for independence and one-way Analysis of Variance (ANOVA) was used to determine the significant association between domains of oral care practices and demographic factors. P values less than 0.05 was considered statistically significant.ResultsA total of 346 healthcare professionals participated in this online study. Most participants (94.3%) responded that they perceived oral health to be of high importance. However, less than two thirds of the participants (59.0%) included oral health questions during antenatal health assessments. Moreover, only 16.2% of participants frequently discussed the importance of oral care with their antenatal patients.ConclusionsIn this survey, most healthcare professionals viewed oral health to be of high importance for prenatal/antenatal patients. However, not all put those views into practice with regard to oral care in pregnant women.

Barriers to optimal breastfeeding of medically complex children in the UK paediatric setting: a mixed methods survey of healthcare professionals.

Breastfeeding is indisputably significant for infants and children, as well as their mothers. However, when breastfed children are admitted to the paediatric ward, they may experience breastfeeding modification due to clinical challenges, lack of staff training and institutional barriers. Although previous research has identified multiple barriers to optimal feeding within the maternity, neonatal and community settings, we know less about the barriers that exist in paediatrics. Paediatric healthcare staff attitudes, training and awareness as well as ward culture are likely to have an impact on the experiences of families but are relatively unresearched in the paediatric setting, especially with regard to the multidisciplinary nature of clinical paediatric care. The aim of this study was to explore the attitudes, awareness and perceived barriers to effective breastfeeding support provision, as well as healthcare professional perception of barriers for families. This was a mixed methods study utilising a questionnaire which was completed by 409 healthcare professionals who identified as working within the paediatric setting. It included responses from paediatricians of all training grades, nurses, healthcare assistants and allied health professionals. Qualitative data from professionals were analysed to develop themes around professional and perceived parent barriers to optimal breastfeeding. This study explored the barriers experienced by staff, as well as professionals' perception of parent barriers. These included lack of knowledge of how to help, a default formula culture, the pressure of maintaining strict fluid balance and breastfeeding being a low priority in the face of critical illness. Of the paediatric departments represented by this sample of healthcare professionals, most had a relatively poor culture of supporting breastfeeding, with multiple institutional barriers identified. Most professionals felt that there was not enough support for breastfeeding families on an average shift, and a large proportion identified as being one of just a few breastfeeding advocates on their ward. In this relatively motivated and experienced sample of healthcare professionals, there were many identified barriers to optimal breastfeeding which could potentially be addressed by training that is carefully nuanced for the paediatric population. Ensuring that paediatric multidisciplinary healthcare professionals have sufficient skills and knowledge would address the identified challenge of poor awareness of breastfeeding and of how to overcome clinical lactation obstacles. Further improvements at policy level need to address the systemic lack of resourcing in paediatrics, as well as the lack of embedded breastfeeding-friendly organisational structures.

Development of a Moral Resilience Collaborative Program During a Pandemic.

Elevated psychological stress can lead to moral distress affecting health care workers and organizations affecting patient care, job satisfaction, and retention. A Moral Resilience Collaborative program was implemented through an academic partnership between a school of nursing and a rehabilitation facility to provide the health care workers in the facility the skills necessary for self-management of moral distress and move them toward moral resilience. Moral distress and resiliency were measured pre-implementation using the Measure of Moral Distress for Healthcare Professionals (MMD-HP) and Short Resiliency Survey (SRS), respectively. Unfortunately, postsurvey quantitative data collection failed due to COVID-19 surges though qualitative data obtained during debriefing sessions demonstrated effectiveness of the project. Based on debriefing comments and the preimplementation MMD-HP mean score and SRS decompression score, the staff in this facility experienced similar types of moral distress as those working in acute care or critical care settings. Even when resiliency programs are needed the most and readily available, patient care demands, a busy work environment, and external factors can hinder staff participation in such endeavors.

Pan-Canadian survey on the impact of the COVID-19 pandemic on cervical cancer screening and management: cross-sectional survey of healthcare professionals.

The coronavirus disease 2019 (COVID-19) pandemic has caused disruptions to cancer care by delaying diagnoses and treatment, presenting challenges and uncertainties for both patients and physicians. We conducted a nationwide online survey to investigate the effects of the pandemic and capture modifications, prompted by pandemic-related control measures, on cervical cancer screening-related activities from mid-March to mid-August 2020, across Canada. The survey consisted of 61 questions related to the continuum of care in cervical cancer screening and treatment: appointment scheduling, tests, colposcopy, follow-up, treatment of pre-cancerous lesions/cancer, and telemedicine. We piloted the survey with 21 Canadian experts in cervical cancer prevention and care. We partnered with the Society of Canadian Colposcopists, Society of Gynecologic Oncology of Canada, Canadian Association of Pathologists, and Society of Obstetricians and Gynecologists of Canada, which distributed the survey to their members via email. We reached out to family physicians and nurse practitioners via MDBriefCase. The survey was also posted on McGill Channels (Department of Family Medicine News and Events) and social media platforms. The data were analyzed descriptively. Unique responses were collected from 510 participants (November 16, 2020, to February 28, 2021), representing 418 fully and 92 partially completed surveys. Responses were from Ontario (41.0%), British Columbia (21.0%), and Alberta (12.8%), and mostly comprised family physicians/general practitioners (43.7%), and gynecologist/obstetrician professionals (21.6%). Cancelled screening appointments were mainly reported by family physicians/general practitioners (28.3%), followed by gynecologist/obstetrician professionals (19.8%), and primarily occurred in private clinics (30.5%). Decreases in the number of screening Pap tests and colposcopy procedures were consistently observed across Canadian provinces. About 90% reported that their practice/institution adopted telemedicine to communicate with patients. The area most severely impacted by the pandemic was appointment scheduling, with an important level of cancellations reported. Survey results may inform resumptions of various fronts in cervical cancer screening and management. The present work was supported by the Canadian Institutes of Health Research (operating grant COVID-19 May 2020 Rapid Research Funding Opportunity VR5-172666 Rapid Research competition and foundation grant 143347 to Eduardo L Franco). Eliya Farah and Rami Ali each received an MSc stipend from the Department of Oncology, McGill University.

Variations in Genomic Testing in Non-small Cell Lung Carcinoma: A Healthcare Professional Survey of Current Practices in the UK.

This survey aims to understand the current UK practice for non-small cell lung carcinoma (NSCLC) and identify barriers that may impact patient treatment and outcomes. In March-June 2021, 57 interviews were conducted with healthcare professionals involved in the secondary care management of patients with NSCLC. Most respondents performed genetic testing at onsite and non-genomic laboratory hub (GLH) offsite locations. The most common genetic tests were EGFR T790M variant (100%), EGFR exon 18-21 covered (95%) and BRAF (93%). No targeted therapy (TT) available (69%), lack of access to a TT (54%) or excessive molecular testing turnaround times (39%) were the most common reasons for using an immuno-oncology therapy over a TT in the first-line setting. The survey highlights variation in mutation testing practices across the UK, which may impact treatment decisions and contribute to health outcome inequality.

Is perinatal substance abuse falling through the cracks?

Perinatal substance abuse (PSA) is associated with increased risk of prematurity, low birth weight, neonatal abstinence syndrome, behavioral issues and learning difficulties. It is imperative that robust care pathways are in place for these high-risk pregnancies and that staff and patient education are optimized. The present study explores the knowledge and attitudes of healthcare professionals toward PSA to identify knowledge gaps to enhance care and reduce stigma. This is a cross-sectional study using questionnaires to survey healthcare professionals (HCPs) working in a tertiary maternity unit (n = 172). The majority of HCPs were not confident in the antenatal management (75.6%, n = 130) or postnatal management (67.5%, n = 116) of PSA. More than half of HCPs surveyed (53.5%, n = 92) did not know the referral pathway and 32% (n = 55) did not know when to make a TUSLA referral. The vast majority (96.5%, n = 166) felt that they would benefit from further training, and 94.8% (n = 163) agreed or strongly agreed that the unit would benefit from a drug liaison midwife. Among study participants, 54.1% (n = 93) agreed or strongly agreed that PSA should be considered a form of child abuse and 58.7% (n = 101) believe that the mother is responsible for damage done to her child. Our study highlights the urgent need for increased training on PSA to enhance care and reduce stigma. It is imperative that staff training, drug liaison midwives and dedicated clinics are introduced to hospitals as a matter of high priority.

Video consultations in reproductive medicine: Safety, feasibility and patient satisfaction

ObjectiveTo study the safety and feasibility of virtual consultations in reproductive medicine. DesignThis was a descriptive cross-sectional study involving subfertile patients attending a video consultation between September 2021 and August 2022. Clinicians conducting virtual consultations during the same period responded to a parallel survey for healthcare professionals. SettingUniversity Hospital in Manchester, UK. ParticipantsSubfertile patients attending a virtual consultation. Healthcare professionals conducting virtual consultations. InterventionThe survey link was offered in 4,932 consultations. A total of 577 (11.69%) patients responded and 510 completed the questionnaire (88.3%). Main outcome measuresPatient satisfaction measured as the percentage of patients preferring virtual to in person consultations. ResultsThe majority of the patients (475, 91.70%) had a positive experience with the video consultation and just under half of the patients (152, 48.65%) preferred a video consultation to an in person consultation due to cost and time savings. Most patients (375, 72.68%) felt safer and less exposed to COVID-19. When the risk of COVID-19 subsides, 242 patients (47%) would still prefer to attend video consultations, while 169 (32.82%) had no preference. Analysis of the responses from patients reporting a negative experience identified technical problems as a possible cause. The virtual consultations appeared to be suitable for patients with disabilities. The clinicians’ survey identified potential legal and ethical concerns. ConclusionVirtual consultations are a safe and feasible alternative to in person consultations for subfertile patients. This large cross-sectional study revealed a high rate of patient satisfaction. Appropriate patient selection accounting for IT literacy, English language understanding and preference is crucial for successful virtual consultations. Further consideration should be given to ethical and legal challenges of virtual consultations. Trial registration: Research Registry, UIN 6912, https://www.researchregistry.com/browse-the-registry

Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension

BackgroundWe aimed to create a multidisciplinary consensus clinical guideline for best practice in the diagnosis, investigation and management of spontaneous intracranial hypotension (SIH) due to cerebrospinal fluid leak based on...