Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study

Andersson, Anna-Lena; Frödin, Maria; Dellenborg, Lisen; Wallin, Lars; Hök, Jesper; Gillespie, Brigid M.; Wikström, Ewa

doi:10.1186/s12913-017-2783-1

Cited by 19 publications

(33 citation statements)

References 66 publications

(48 reference statements)

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“…Hospitals are complex organizations characterized by caring for people in great need, as well as by different professional groups, disciplines and knowledge that are often hierarchically related (Erichsen Andersson et al, 2018;Wolf, Ekman, & Dellenborg, 2012). Ethnography is a research method that is beneficial to use when there is limited knowledge of the research subject, as well as its culture and its interpretations (Long et al, 2008).…”

Section: Methodsmentioning

confidence: 99%

Midwives’ care on a labour ward prior to the introduction of a midwifery model of care: a field of tension

Nilsson

Ólafsdóttir

Lundgren

et al. 2019

International Journal of Qualitative Studies on Health and Well

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Purpose: There is a need to deepen knowledge about midwives' care in obstetric-led labour wards in which midwives are responsible for normal births. This ethnographic study explores the content and meaning of midwives' care of women in a hospital-based labour ward in Sweden prior to the introduction of a theoretical midwifery model of care. Methods: Data were gathered through participant observation, analysed through interpretation grounded in reflexivity discussions and are presented in the form of ethnographic descriptions. Results: The midwives' care was provided in a field of tension in which they had to balance contrasting models of care, described in the themes: The birthing rooms and the office-Different rooms of care, Women giving birth or being delivered-Midwives' expectations and relationships with women, Old and new caring roles of the midwife-Women giving birth in a "new age", Being and doing-Different approaches to caring, and Holistic and reductionist care-Guided by contrasting models and guidelines. The midwives' freedom to act as autonomous professionals was hindered by medical and institutional models of care and this led to uncertainty regarding their roles as midwives. Conclusions: Midwives having to balance their activities in a field of tension require midwifery models that can guide their practice.

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Section: Methodsmentioning

confidence: 99%

Midwives’ care on a labour ward prior to the introduction of a midwifery model of care: a field of tension

Nilsson

Ólafsdóttir

Lundgren

et al. 2019

International Journal of Qualitative Studies on Health and Well

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“…This article is part of the Safe Hands Study: ClinicalTrials.gov (ID: NCT02983136), published elsewhere. 41 The implementation intervention description is found in Table 2.…”

Section: Methodsmentioning

confidence: 99%

The Safe Hands Study: Implementing aseptic techniques in the operating room: Facilitating mechanisms for contextual negotiation and collective action

Wikström

Dellenborg

Wallin

et al. 2019

American Journal of Infection Control

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Background: Even though hand hygiene and aseptic techniques are essential to provide safe care in the operating room, several studies have found a lack of successful implementation. The aim of this study was to describe facilitative mechanisms supporting the implementation of hand hygiene and aseptic techniques. Methods: This study was set in a large operating room suite in a Swedish university hospital. The theorydriven implementation process was informed by the literature on organizational change and dialogue. Data were collected using interviews and participant observations and analyzed using a thematic approach. The normalization process theory served as a frame of interpretation during the analysis. Results: Three facilitating mechanisms were identified: (1) commitment through a sense of urgency, requiring extensive communication between the managers, operating room professionals, and facilitators in building commitment to change and putting the issues on the agenda; (2) dialogue for co-creation, increasing and sustaining commitment and resource mobilization; and (3) tailored management support, including helping managers to develop their leadership role, progressively involving staff, and retaining focus during the implementation process. Conclusions: The facilitating mechanisms can be used in organizing implementation processes. Putting the emphasis on help and support to managers seems to be a crucial condition in complex implementation processes, from preparation of the change process to stabilization of the new practice.

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“…The first author is a social anthropologist who has extensive experience of conducting ethnographic fieldwork in Senegal (Dellenborg 2004 , 2007 , 2009 ) as well as in various healthcare settings in Sweden (Dellenborg et al 2012 ; Wolf et al 2012 ; Skott et al 2013 ; Erichsen Andersson et al 2018 ; Dellenborg and Lepp 2018 ). The second author (EW) is a researcher who has extensive experience of organization studies and implementation research in the healthcare sector (Grill et al 2014 ; Arman et al 2014 ; Wigert and Wikström 2014 ; Grill et al 2015 ; Liff and Wikström 2015 ).…”

Section: Methodological Considerations For the Studymentioning

confidence: 99%

“…The second author (EW) is a researcher who has extensive experience of organization studies and implementation research in the healthcare sector (Grill et al 2014 ; Arman et al 2014 ; Wigert and Wikström 2014 ; Grill et al 2015 ; Liff and Wikström 2015 ). The third author (AEA) is a researcher who has specialized in implementation research in hospital settings (Andersson et al 2012 , 2014 , 2015 ; Erichsen Andersson et al 2015 , 2018 ).…”

Section: Methodological Considerations For the Studymentioning

confidence: 99%

“…We observed that the physicians’ resistance was met with interest by the facilitators but not by the managers. It is broadly recognized that the management leaders’ approach and ability to handle resistance to change with an attitude of curiosity and respect, and by adopting an inquiring rather than disapproving approach, is essential for implementation success (Loup 2005 ; Weiner 2009 ; Erichsen Andersson et al 2018 ).…”

Section: Understanding Physicians’ Resistance In Contextmentioning

confidence: 99%

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Factors that may promote the learning of person-centred care: an ethnographic study of an implementation programme for healthcare professionals in a medical emergency ward in Sweden

Dellenborg

Wikström

Erichsen

2019

Adv in Health Sci Educ

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While person-centred care has gained increasing prominence in recent decades as a goal for healthcare systems, mainstream implementation remains tentative and there is a lack of knowledge about how to develop person-centred care in practice. This study therefore aimed to explore what may be required in order for person-centred care programmes to be successful. The study used an ethnographic method of data collection. This consisted of closely following an implementation programme on a medical emergency ward in a Swedish hospital. Data consisted of participant observation and informal interviews with healthcare providers and their management leaders while they were in the process of training to use person-centred care. These interlocutors were using action learning methods under the guidance of facilitators. Our findings revealed that although the programme resulted in some of the processes that are central for person-centred care being developed, organisational factors and a lack of attention to ethics in the programme counteracted these positive effects. The study highlights the importance of facilitating mechanisms to produce desired results. These include management leaders’ learning about the dynamic and collective nature of learning processes and change. They also include allowing for inter-professional dialogue to enable managers and professionals to reflect deeply on professional boundaries, disciplinary knowledge and power relations in their teams. Teamwork is essential for the development of person-centred care and documentation, in accordance with this specific implementation programme, is also indispensable. The space for inter-professional dialogue should also accommodate their various perspectives on the aims of care and organizational reality.

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Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study

Cited by 19 publications

References 66 publications

Midwives’ care on a labour ward prior to the introduction of a midwifery model of care: a field of tension

Midwives’ care on a labour ward prior to the introduction of a midwifery model of care: a field of tension

The Safe Hands Study: Implementing aseptic techniques in the operating room: Facilitating mechanisms for contextual negotiation and collective action

Factors that may promote the learning of person-centred care: an ethnographic study of an implementation programme for healthcare professionals in a medical emergency ward in Sweden

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