Critical Thinking

Braun, Debra; Barnhardt, Kim

doi:10.1097/cnq.0000000000000003

Cited by 5 publications

(4 citation statements)

References 2 publications

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“…This study highlights the importance of understanding and improving human work as described by Shorrock ( 7 – 9 ) about the 9 proxies of work-as-done, such as work-as-imagined, work-as-prescribed, work-as-disclosed, work-as-analyzed, work-as-observed, work-as-simulated, work-as-instructed, work-as-measured, and work-as-judged, especially in the context of designing PICU in health care. There is a need to explore each of these aspects in a systematic manner.…”

Section: Discussionmentioning

confidence: 61%

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What you see may not be what you get! Simulate towards effective planning of pediatric intensive care unit

et al. 2022

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Aims and objectivesThis study aimed to describe the application of low-cost inter-professional simulation over 4 phases in identifying structural and design issues, latent safety threats as well as test systems, processes, including facilitated team training during the design of a new pediatric intensive care unit (PICU).Materials and methodsThe four-phase inter-professional simulation sessions involving clinical and non-clinical teams were conducted over a 3-month period in a corporate hospital during the designing of a new PICU. Low-cost resources, such as floor tapes, low-tech manikins, reused sterilized consumables, and actual patient beds and equipment, were used for the in situ simulation sessions. A plus-delta method of debriefing was done, and changes agreed on consensus were implemented after each simulated session.ResultsThere were 10 simulation sessions conducted over 4 phases during the 3-month period of designing the PICU. The participants included 10 doctors from PICU and adult critical care, 25 critical care nurses, 12 members from the project team, and 2 hospital administrators in various combinations. The first phase led to the re-design of workspace and clinical areas for better space utilization. The second phase required further revision to facilitate better mobility and facilities. In the third phase, the number of beds was reduced to 6 beds following the simulated drills involving the actual placement of patient cots and equipment. The fourth phase had thematic 5 simulated exercises involving the newly recruited clinical teams that enabled the identification of systems and process issues. Cognitive aids and video orientation of the setup, team training, and human factors training were addressed, and the unit was open for patient care in a week.ConclusionA phased inter-professional simulation exercise with low-cost resources can enable the identification of structural challenges, design issues, latent safety threats, test systems, processes, patient flow, and facilitated team training during the design of a new PICU. Further studies are needed to understand the generalization of the study findings into designing PICU.

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Section: Discussionmentioning

confidence: 61%

“…There is a need to explore each of these aspects in a systematic manner. The participation of the clinical teams, inter-professional teams, and end users in an in situ simulated exercise is a key to addressing the gaps in safety and service as described in this study (9)(10)(11).…”

Section: Discussionmentioning

confidence: 99%

What you see may not be what you get! Simulate towards effective planning of pediatric intensive care unit

et al. 2022

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“…Sensory cues, structural aspects, decorations, and ornaments are the most important elements of the healing environment that should be considered when planning and designing the care settings. 22,28,125…”

Section: Subjective Nursing Outcomes Can Be Modulated By Contextuamentioning

confidence: 99%

The impact of contextual factors on nursing outcomes and the role of placebo/nocebo effects: a discussion paper

Palese

Rossettini²,

Colloca

et al. 2019

PR9

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Introduction:Placebo and nocebo effects represent one of the most fascinating topics in the health care field.Objectives:the aims of this discussion paper were (1) to briefly introduce the placebo and nocebo effects, (2) to elucidate the contextual factors able to trigger placebo and nocebo effects in the nursing field, and (3) to debate the impact of contextual factors on nursing education, practice, organisation, and research.Methods:a narrative review was conducted based on the available evidence.Results:Placebo responses (from Latin “I shall please”) are a beneficial outcome(s) triggered by a positive context. The opposite are the nocebo effects (from Latin “I shall harm”), which indicates an undesirable outcome(s) caused by a negative context. Both are complex and distinct psychoneurobiological phenomena in which behavioural and neurophysiological changes arise subsequent to an interaction between the patient and the health care context.Conclusion:Placebo and nocebo concepts have been recently introduced in the nursing discipline, generating a wide debate on ethical issues; however, the impact on nursing education, clinical practice, nursing administration, and research regarding contextual factors triggering nocebo and placebo effects has not been debated to date.

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“…Therefore, architecture may play a role in the management of PD patients, being relevant when planning, designing, and constructing physical structures, encompassing both housing and urban spaces. For instance, architectural features of the built environment are acknowledged to be essential for independence and health outcomes of older people [17] and some patients with neurodisabilities, such as those resulting from dementia [18][19][20][21][22][23][24][25] and stroke [26,27]. However, this line of inquiry has been largely neglected in people with PD, with only 9% of patients being referred to therapists specialized in home environment risk assessments [28,29].…”

Section: Introductionmentioning

confidence: 99%

The Role of Architecture and Design in the Management of Parkinson’s Disease: A Systematic Review

Ramos

Duarte

Bouça‐Machado

et al. 2020

JPD

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Background: Parkinson’s disease (PD) is a neurological condition characterized by the development of daily disabling symptoms. Although the architecture and design of a PD patient’s environment can hinder or facilitate full participation in daily activities, their putative role in the management of these patients has received little attention to date. Objective: We conducted a systematic review to evaluate the evidence of architectural and design features in the management of people with PD. Methods: An electronic database search of observational and experimental studies was conducted in MEDLINE and Embase from inception to May 2020, with two independent reviewers identifying the studies. Falls, fear of falling, postural instability, gait impairment/disability, and functional mobility were our outcomes of interest. Results: Thirty-six studies were included, among which nineteen were observational and seventeen were experimental studies (overall participants = 2,965). Pavement characteristics, notably unstable surfaces and level differences, were found to be a major cause of falling. Ground-based obstacles and confined/narrowed spaces were found to disturb gait, increase postural instability, and decrease functional mobility. Housing type did not appear to increase risk of falling, nor to significantly explain concerns about falling. Conclusion: Findings suggest a need to adjust architectural features of the surrounding space to ensure appropriate care and provide a safe environment to PD patients. More evidence about the impact of such modifications on PD outcomes is needed.

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Critical Thinking

Cited by 5 publications

References 2 publications

What you see may not be what you get! Simulate towards effective planning of pediatric intensive care unit

What you see may not be what you get! Simulate towards effective planning of pediatric intensive care unit

The impact of contextual factors on nursing outcomes and the role of placebo/nocebo effects: a discussion paper

The Role of Architecture and Design in the Management of Parkinson’s Disease: A Systematic Review

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