Efficient, accurate, and timely communication is required for quality health care and is strongly linked to health care staff job satisfaction. Developing ways to improve communication is key to increasing quality of care, and interdisciplinary care teams allow for improved communication among health care professionals. This study examines the patient- and family-centered use of structured interdisciplinary bedside rounds (SIBR) on an acute care for the elderly (ACE) unit in a 555-bed metropolitan community hospital. This mixed methods study surveyed 24 nurses, therapists, patient care assistants, and social workers to measure perceptions of teamwork, communication, understanding of the plan for the day, safety, efficiency, and job satisfaction. A similar survey was administered to a control group of 38 of the same staff categories on different units in the same hospital. The control group units utilized traditional physician-centric rounding. Significant differences were found in each category between the SIBR staff on the ACE unit and the control staff. Nurse job satisfaction is an important marker of retention and recruitment, and improved communication may be an important aspect of increasing this satisfaction. Furthermore, improved communication is key to maintaining a safe hospital environment with quality patient care. Interdisciplinary team rounds that take place at the bedside improve both nursing satisfaction and related communication markers of quality and safety, and may help to achieve higher nurse retention and safer patient care. These results point to the interconnectedness and dual benefit to both job satisfaction and patient quality of care that can come from enhancements to team communication.
Purpose-The purpose of this study was to a) describe spiritual well-being (existential and religious well-being) in adolescents with inflammatory bowel disease (IBD) versus healthy peers, b) examine associations of spiritual well-being with mental health outcomes (emotional functioning and depressive symptoms), and c) assess the differential impact of existential versus religious well-being on mental health.Methods-One-hundred fifty-five adolescents ages 11-19 from a children's hospital and a university hospital filled out questionnaires including the Spiritual Well-Being Scale, the Children's Depression Inventory-Short Form, and the Pediatric Quality of Life Inventory. Covariates in multivariable models included demographics, disease status, and interactions.Results-Participant's mean (SD) age was 15.1 (2.0) years; 80 (52%) were male; and 121 (78%) were White. Levels of existential and religious well-being were similar between adolescents with IBD and healthy peers. In multivariable analyses, existential well-being was associated with mental health (partial R 2 change = .08-.11, p < .01) above and beyond other characteristics (total R 2 = .23, p < .01). Presence of disease moderated both the relationship between existential well-being and emotional functioning, and between religious well-being and depressive symptoms -that is, the relationships were stronger in adolescents with IBD as compared to healthy peers. Religious wellbeing was only marginally significantly associated with mental health after controlling for other factors.REPRINTS AND CORRESPONDENCE: Sian Cotton, PhD, Department of Family Medicine and the Center for the Study of Health, University of Cincinnati Academic Health Center, P.O. Box 670840, Cincinnati, OH 45267-0840; Fax: 513-558-2744; E-mail: E-mail: sian.cotton@uc.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-While both healthy adolescents and those with IBD had high levels of spiritual well-being, having IBD moderated the relationship between spiritual well-being and mental health. Meaning/purpose was related to mental health more so than connectedness to the sacred. NIH Public AccessAdolescents with a chronic illness often face numerous psychosocial and medical issues [1][2][3][4][5]. Inflammatory bowel disease (IBD), comprising ulcerative colitis and Crohn's disease, is characterized by chronic and relapsing inflammation of the gastrointestinal tract, and its manifestations may include abdominal pain, bloody diarrhea, and/or nausea and vomiting. Approximately 15-25% of cases of IBD are present by 20 years of age, with an ...
Background: Family medicine offices may play an important role in the transmission of common illnesses such as upper respiratory tract infections (URTIs). There has, however, been little study of whether physicians teach patients about URTI transmission and what their own actions are to prevent infection. The purpose of this study was to assess the quality of hand hygiene and the frequency with which family physicians and staff touch their eyes, nose, and mouth (the T-zone) as well as physician and staff self-reported behaviors and recommendations given to patients regarding URTI prevention.Methods: We observed family physicians and staff at 7 offices of the Cincinnati Area Research and Improvement Group (CARInG) practice-based research network for the quality of hand hygiene and number of T-zone touches. After observations, participants completed surveys about personal habits and recommendations given to patients to prevent URTIs.Results: A total of 31 clinicians and 48 staff participated. They touched their T-zones a mean of 19 times in 2 hours (range, 0 -105 times); clinicians did so significantly less often than staff (P < .001). We observed 123 episodes of hand washing and 288 uses of alcohol-based cleanser. Only 11 hand washings (9%) met Centers for Disease Control and Prevention criteria for effective hand washing. Alcohol cleansers were used more appropriately, with 243 (84%) meeting ideal use. Participants who were observed using better hand hygiene and who touched their T-zone less report the same personal habits and recommendations to patients as those with poorer URTI prevention hygiene.Conclusions: Clinicians and staff in family medicine offices frequently touch their T-zone and demonstrate mixed quality of hand cleansing. Participants' self-rated URTI prevention behaviors were not associated with how well they actually perform hand hygiene and how often they touch their T-zone. The relationship between self-reported and observed behaviors and URTIs in family medicine office settings needs further study. (J Am Board Fam Med 2014;27:339 -346.)
Background: Physicians are being asked to report errors from primary care, but little is known about how they apply the term "error." This study qualitatively assesses the relationship between the variety of error definitions found in the medical literature and physicians' assessments of whether an error occurred in a series of clinical scenarios.
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