Health-care professionals' documentation of wellbeing in patients following open heart surgery: a content analysis of medical records

Karlsson, Ann‐Kristin; Lidell, Evy; Johansson, Mats

doi:10.1111/j.1365-2834.2012.01458.x

Cited by 8 publications

(9 citation statements)

References 24 publications

(46 reference statements)

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“…There is no commonly accepted sample size for qualitative studies, as it depends on richness of data [28]. In the current study we obtained no additional information after approximately 50 EMS records had been analyzed in the content analysis of patients admitted during 2012, but continued to analyze a total of 80 records in accordance with previously published analyzes of medical records [30, 31]. …”

Section: Methodsmentioning

confidence: 99%

Presentations of adult septic patients in the prehospital setting as recorded by emergency medical services: a mixed methods analysis

Wallgren

Bohm

Kurland

2017

Scand J Trauma Resusc Emerg Med

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BackgroundCurrent sepsis screening tools rely on vital parameters which are, however, normal in one third of patients with serious infections. Therefore, there is a need to include other variables than vital parameters to identify septic patients. Our primary aim was to identify and quantify keywords related to the septic patients’ symptom presentation in the prehospital setting. The secondary aims were to compare keywords in relation to in-hospital mortality and the distribution of keywords in relation to age categories, survivors/ deceased and severe/ non-severe sepsis.MethodsA mixed methods analysis using a sequential exploratory design was performed, starting with a content analysis of presentations of septic patients as documented in Emergency Medical Services (EMS) records (n = 80) from 2012, to identify keywords related to sepsis presentation. Thereafter, the identified keywords were quantified among 359 septic patients from 2013. All patients were adults, admitted to Södersjukhuset and discharged with an ICD-10-code (International Classification of Diseases, Tenth Revision) compatible with sepsis.ResultsThe most common keywords related to septic patients’ symptom presentation were: abnormal/ suspected abnormal temperature (64.1.%), pain (38.4%), acute altered mental status (38.2%), weakness of the legs (35.1%), breathing difficulties (30.4%), loss of energy (26.2%) and gastrointestinal symptoms (24.0%). There was an association between keywords and in-hospital mortality. Symptoms varied between age categories, survivors/ deceased and severe/ non-severe sepsis.DiscussionThis is, to the best of our knowledge, the first study exploring the symptom presentation as documented by EMS, of septic patients in the prehospital setting. Keywords related to patients´ symptom presentation recurred in the EMS records of septic patients, so that a pattern was discernible. In addition, certain symptom presentations were associated with increased in-hospital mortalityConclusionsInformation relating to symptom presentation is not included in current sepsis screening tools. We suggest that keywords related to patients´ symptom presentation could be integrated into screening tools and may thus increase the identification of sepsis, and potentially also identify high-risk patients. However, as a first step, the specificity of these keywords, with respect to sepsis, needs to be examined.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-017-0367-z) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Presentations of adult septic patients in the prehospital setting as recorded by emergency medical services: a mixed methods analysis

Wallgren

Bohm

Kurland

2017

Scand J Trauma Resusc Emerg Med

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“…41 Practice can alter negatively through bureaucratic demands for rigid adherence to guidelines, protocols, and rules. 42 This distortion in values is evident in patient records. The focus is on physical aspects at the expense of holistic, patient-centered care.…”

Section: Revealing a Pattern Of Organizational Knowingmentioning

confidence: 99%

“…A vicious circle develops; each time that harm is revealed, organizations set in place more rules. 42 Doing good and avoiding harm were often contrasted by participants. They felt that the model of managerial utilitarianism predominated inside the NHS.…”

Section: Revealing a Pattern Of Organizational Knowingmentioning

confidence: 99%

Expert Nurses' Perceptions of the Relevance of Carper's Patterns of Knowing to Junior Nurses

Terry

Carr

Curzio

2017

Advances in Nursing Science

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This study explored with expert nurses in the UK how nursing wisdom can be developed in new and junior nurses. Carper's patterns of knowing and Benner's novice-to-expert continuum formed the theoretical framework. Employing a constructionist research methodology with participant engagement in co-construction of findings, data were collected via 2 separate cycles comprising 4 consecutive sessions followed by a nationally advertised miniconference. Empirical, ethical, personal, and esthetic knowing was considered evident in junior nurses. Junior nurses in the UK seem to lack a previously unrecognized domain of organizational knowing without which they cannot overcome hegemonic barriers to the successful development of nursing praxis.

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“…PROMs can play an important role in patient-centered healthcare as discussing health outcomes in the patient-clinician interaction may lead to the patient becoming more involved in goal setting, improve the effectiveness of the patient-clinician relationship, and increase the patient’s self-efficacy [ 4 5 6 ]. Especially in frail older patients and other patients with multiple long-term diseases, the use of PROMs may support patients in the process of self-monitoring [ 7 ].…”

Section: Multipurpose Application Of Promsmentioning

confidence: 99%

“…Even in the most intensive treatments the structural attention for impact on general wellbeing is limited. While for example the physical domain was meticulously described during trajectories of open heart surgery, notes on subjective wellbeing could only be found in less than half or in one out of ten patients [ 5 ]. Therefore, we will subsequently give an update for health care professionals, managers and policy makers based on our long lasting research and clinical practice on the multiple purposes PROMs can serve, and how this can improve their implementation and integration of patients’ and professionals’ interests in daily practice.…”

Section: Introductionmentioning

confidence: 99%

Using Patient Reported Outcomes Measures to Promote Integrated Care

Rikkert¹,

Wees²,

Schoon³

et al. 2018

International Journal of Integrated Care

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Introduction:Patient reported outcome measures (PROMs) have been introduced as standardised outcomes, but have not been implemented widely for disease targeted pathways of care, nor for geriatric patients who prefer functional performance and quality of life.Discussion:We describe innovative multipurpose implementation of PROMs as evidenced by two best practices of PROMs application in geriatric and physiotherapy practice. We show that PROMs can show meaningful outcomes in older subjects’ patient journeys, which can at the same time serve individuals and groups of both patients and professionals.Key lesson:PROMs can deliver generic outcomes relevant for older patients, may improve patient-physician relationship, quality of care and prediction of future outcomes in geriatric care, if they are valid, reliable and responsive, but still short and simple. A precondition to make the hard tip from research to practice is that PROMs are carefully positioned in the clinical encounters and in electronic health records.

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Health-care professionals' documentation of wellbeing in patients following open heart surgery: a content analysis of medical records

Abstract: Managers need to support and work for a patient-centred approach in cardiac care, resulting in patient documentation that reflects patient wellbeing as a whole.

Cited by 8 publications

References 24 publications

Presentations of adult septic patients in the prehospital setting as recorded by emergency medical services: a mixed methods analysis

Presentations of adult septic patients in the prehospital setting as recorded by emergency medical services: a mixed methods analysis

Expert Nurses' Perceptions of the Relevance of Carper's Patterns of Knowing to Junior Nurses

Using Patient Reported Outcomes Measures to Promote Integrated Care

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