Co-designed and consensus based development of a quality improvement checklist of patient and family-centered actionable processes of care for adults with persistent critical illness

Clinician‐perceived barriers and facilitators for the provision of actionable processes of care important for persistent or chronic critical illness

“…At the policy level, participants reported a lack of formalized training at the professional curriculum level, mirroring barriers reported by participants at the intrapersonal level. Participant offered additional insights about how to reconcile the incongruence felt between setting, training, and the expectations to provide high‐quality P/CCI patients, adding to a growing body of research aimed at better understanding the specific care needs for patients and family with P/CCI (Harrison et al., 2023; Rose, Istanboulian, et al., 2022). Professionally, diverse participants including nurses reported barriers and facilitators that included but transcended the intrapersonal and interpersonal levels suggesting the need to transform critical care processes and models (i.e., teams) for patients with P/CCI.…”

“…This study is part of a larger research programme aimed at developing tools and strategies to improve the experiences and outcomes of P/CCI patients and their families (Rose et al., 2019; Rose, Allum, et al., 2022; Rose, Istanboulian, et al., 2022). Our previous systematic review identified 42 distinct actionable processes of care for patients with P/CCI of potential relevance (Rose et al., 2019).…”

“…We then conducted interviews with ICU clinicians (December 2018 – February 2019) that contributed to a total of 47 actionable processes of care. Following these interviews, we conducted a consensus process with 138 ICU clinician, patients and family member participants to prioritize the top actionable processes of care from the list of 47 for inclusion in a quality improvement checklist (Rose, Istanboulian, et al., 2022). We obtained consensus on 11 core domains: patient and family involvement in decision‐making; patient communication; physical comfort and complication prevention; promoting self‐care and normalcy; ventilator weaning; physical therapy; swallowing; pharmacotherapy; psychological issues; delirium; and appropriate referrals (Rose, Istanboulian, et al., 2022).…”

“…Following these interviews, we conducted a consensus process with 138 ICU clinician, patients and family member participants to prioritize the top actionable processes of care from the list of 47 for inclusion in a quality improvement checklist (Rose, Istanboulian, et al., 2022). We obtained consensus on 11 core domains: patient and family involvement in decision‐making; patient communication; physical comfort and complication prevention; promoting self‐care and normalcy; ventilator weaning; physical therapy; swallowing; pharmacotherapy; psychological issues; delirium; and appropriate referrals (Rose, Istanboulian, et al., 2022). We subsequently conducted this secondary analysis of the clinician interviews applying a multi‐level ecological framework (i.e., Social‐Ecological Model) (McLeroy, Bibeau, et al., 1988; McLeroy, Steckler, et al., 1988) to better understand drivers (i.e., barriers and facilitators) to implementation of these care processes.…”

Effectiveness of Structured Teaching Programme on Knowledge regarding Menstrual Hygiene among Adolescent Girls

“…The researcher viewed that girls do not wish to attend school during menstruation due to poor sanitation facilities and prefer to use homemade cloth during menstrual (Agarwal et al, 2018;Rose et al, 2022;Sharma et al, 2019). As a result, they grow up with low self-esteem and disempowerment from poor educational attainment.…”