Aims and Objectives
To evaluate the relationship between nurse–patient‐initiated participation, nurses' attitudes towards patient's participation, and patients' adherence to treatment. Specifically, to (1) explore nurse–patient participation during haemodialysis and quantify the information into measurable indices; (2) determine the haemodialysis patient's adherence to treatment; (3) describe nurses' attitudes towards patient participation; and (4) establish the relationships between nurse–patient‐initiated participation, nurses' attitudes towards patient participation and patients' adherence to treatment.
Background
To improve haemodialysis patients' health, it is crucial to identify nurses' and patients' factors facilitating adherence to treatment.
Design
An exploratory‐sequential mixed‐methods (quantitative and qualitative) design.
Methods
All nurses working at a dialysis ward (n = 30) and their randomly selected patients (n = 102) participated. Qualitative data on nurse–patient‐initiated participation were derived from transcribed nurse–patient conversations and quantified for further analyses. Nurses' attitudes towards patient participation were collected via questionnaire, and adherence to treatment via observed reduction in prescribed haemodialysis time. [CONSORT‐SPI guidelines].
Results
Content analysis of the conversations indicated that nurse‐initiated participation focused on patient's medical condition, treatment plan and education; while patients initiated more small talk. Non‐adherence to treatment was significant (Mean = 0.19 h; SD = 0.33). Regression analyses indicated that nurses' attitude towards participation was negatively linked to patient adherence, while patient–nurse‐initiated participation was unrelated. Nurses' attitudes towards patient participation moderated the relationship between nurse–patient‐initiated participation and patient adherence: the more positive the attitude towards inclusion the more negative the link between patient or nurse‐initiated participation and patient adherence.
Conclusions
The findings provided paradoxical insights: Nurses' positive attitudes towards participation lead them to accept the patient's position for shortening haemodialysis treatment, so that adherence to care decreases.
Relevance to clinical practice
Nurses require education on negotiating methods to help achieve patient adherence while respecting the patient's opinion. Patients should be educated how to approach nurses, seeking the information they need.
Hyperkalaemia is an electrolyte abnormality that warrants urgent intervention and has well-recognised electrocardiographic changes. Peaking T wave is the most appreciated ECG sign, but hyperkalaemia manifesting electrocardiographically as acute ischemia with ST segment elevation is a very rare condition. We present a case of acute kidney injury, complicated by severe hyperkalaemia causing ST segment elevation changes in ECG simulating acute myocardial infarction. Rapid serum potassium level in arterial blood gases blood test guide treatment in this case saved the need for unnecessary activation of the catheterisation lab and more importantly, saved the patient from malignant dysthymia in case of treatment delay. Aggressive treatment of hyperkalaemia resulted in successful reduction of serum potassium level; ECG changes returned to baseline without any evidence of pseudoinfarction pattern. The medical staff should be aware of this condition in order to administer correct therapy and prevent unnecessary interventions and the associated risk of complications.
Aim
To validate the Hebrew version of the Person‐Centered Care of Older People with Cognitive Impairment in the Acute Care scale.
Background
The Person‐Centered Care of Older People with Cognitive Impairment in Acute Care scale is a reliable and valid measure to assess the extent to which person‐centred care among people with dementia is adopted in the acute care setting.
Methods
A cross‐sectional study using a self‐reporting structured questionnaire was conducted with 678 professionals (69% nurses, 26% physicians, 5% other health care professionals) in five hospitals across Israel.
Results
Similar to other languages, best results were obtained using 14 of the 15 items included in the original scale. Confirmatory factor analysis indicated the appropriateness of a three‐factor structure for the Hebrew version of the scale. Cronbach's alpha scores for these factors were moderate to good.
Conclusions
The Hebrew version of the scale is a reliable and valid tool for assessing hospital professionals' perceptions of person‐centred care.
Implications for Nursing Management
A new language validated version of the scale will allow nurse managers to learn from multiple countries' experience while conducting international comparisons. Such developments will improve and expand the implementation of the person‐centred care among people with dementia in hospital settings.
According to the family-centered approach, the involvement of family in the care of hospitalized older patients is a crucial element of quality care. Active involvement of family in care by the nursing staff depends on different factors, including attitudes towards the importance of family in the care and perception of the interactions with the family. This study aims to identify the factors predicting staff behavior of involving the family in the care process. A cross-sectional study was conducted among 179 nursing staff at a hospital, using a self-report questionnaire examining staff attitudes towards the importance of family in care, the perception of the interactions with the family (family behavior, communication and conflicts), and staff behavior toward family involvement. The findings point out the importance that staff attitudes have on their behavior in the active involvement of family in the care of older patients. Staff behavior of family involvement was predicted by their perceptions of the family (as conversational partners and having their own resources), less conflicts with the family, and staff academic education. Staff behavior toward family is influenced by their attitude and staff–family relationships. Educational programs should emphasize the importance of family, as well as dealing with conflicts.
Background: Reporting a near-miss event has been associated with better patient safety culture. Purpose: To examine the relationship between patient safety culture and nurses' intention to report a nearmiss event during COVID-19, and factors predicting that intention. Methods: This mixed-methods study was conducted in a tertiary medical center during the fourth COVID-19 waves in 2020-2021 among 199 nurses working in COVID-19-dedicated departments. Results: Mean perception of patient safety culture was low overall. Although 77.4% of nurses intended to report a near-miss event, only 20.1% actually did. Five factors predicted nurses' intention to report a nearmiss event; the model explains 20% of the variance. Poor departmental organization can adversely affect the intention to report a near-miss event. Conclusions: Organizational learning, teamwork between hospital departments, transfers between departments, and departmental disorganization can affect intention to report a near-miss event and adversely affect patient safety culture during a health crisis.
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