Patient advocacy by nurses – past, present and future

Water, Tineke; Ford, Katrina; Spence, Deb; Rasmussen, Shayne

doi:10.1080/10376178.2016.1235981

Cited by 33 publications

(32 citation statements)

References 74 publications

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“…Taking action when safety is endangered by others is considered part of nurses’ ethical responsibilities (International Council Of Nurses ), and patient advocacy has been promoted as part of their core responsibilities (Kalaitzidis & Jewell ). However, nurses may find it difficult to effectively practice patient advocacy and address safety issues (Rainer ; Water et al, ). In their review of qualitative studies, Morrow et al, found that speaking up by nurses is negatively affected by power dynamics and hierarchical constraints, experienced through instances of being ignored, disregarded, or disrespected (Morrow et al, ).…”

Section: Discussionmentioning

confidence: 99%

Speaking up about patient safety in psychiatric hospitals – a cross‐sectional survey study among healthcare staff

Schwappach

Niederhauser

2019

Int J Mental Health Nurs

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Speaking up is an important communication strategy to prevent patient harm. The aim of this study was to examine speak up‐related behaviour and climate for the first time in psychiatric hospitals. A cross‐sectional survey was conducted among healthcare workers (HCWs) in six psychiatric hospitals with nine sites in Switzerland. Measures assessed speak up‐related behaviour with 11 items organized in three scales (the frequency of perceived safety concerns, the frequency of withholding voice, and the frequency of speaking up). Speak up‐related climate was assessed by 11 items organized in 3 subscales (psychological safety for speaking up, encouraging environment for speaking up, and resignation). Statistical analyses included descriptive statistics, reliability, correlations and multiple regression analysis, confirmatory factor analysis, and analysis of variance for comparing mean scores between professional groups. A total of 817 questionnaires were completed (response rate: 23%). In different items, 45%–65% of HCWs reported perceived safety concerns at least once during the past four weeks. Withholding voice was reported by 13–25% of HCWs, and speaking up was reported by 53%–72% of HCWs. Systematic differences in scores were found between professional groups (nurses, doctors, psychologists) and hierarchical groups (lower vs higher status). The vignette showed that hierarchical level and perceived risk of harm for the patient were significant predictors for the self‐reported likelihood to speak up. Situations triggering safety concerns occur frequently in psychiatric hospitals. Speaking up and voicing concerns should be further promoted as an important safety measure.

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Section: Discussionmentioning

confidence: 99%

Speaking up about patient safety in psychiatric hospitals – a cross‐sectional survey study among healthcare staff

Schwappach

Niederhauser

2019

Int J Mental Health Nurs

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“…Possible explanations are that the team from the municipality was from another organisation and that nurses role at the meeting are unclear. Water et al [43] described that nurses sometimes are expected to advocate for their patients in institutional cultures in which they lack authority and have limited power.…”

Section: Discussionmentioning

confidence: 99%

A Spider in a Broken Web: Nurses’ Views on Discharge Planning for Older Patients after Hip Fracture Surgery Who Live in their Own Homes in Rural Areas

Segevall¹,

Söderberg²

2018

OJN

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Introduction: The in-hospital rehabilitation of patients who have undergone surgery for hip fracture requires a team-based effort, in which nurses play an all-embracing role throughout the patients' hospital stays. Although discharge planning has been widely studied, little is known about discharge planning from hospitals to homes in rural settings. Aim: To describe nurses' views on discharge planning for older patients after hip fracture surgery who live in their own homes in rural areas. Methods: A qualitative method was used. Four focus group interviews were conducted with 18 nurses who work at an orthopaedic clinic. The interview texts were analysed with qualitative content analysis. Findings: Nurses expressed that patients needed support from healthcare personnel as well as relatives in order to prepare for life at home. They also expressed that patients were not supported in all aspects of discharge planning because they faced difficulties in having their voices heard. Nurses described that many of those aspects were beyond their own control, which had left them with little to non-ability to influence discharge planning. Findings additionally indicate that discharge planning seems not affected by occurring in rural settings. Conclusions: Although discharge planning is intended to meet the unique wishes and needs of each patient given the realities of existing resources, nurses' responsibilities in discharge planning are unclear. This study shows an organisation in which healthcare personnel continue to make decisions for patients. Significance for nurses to perform a discharge planning that support patients' participation seems to be a communication based on shared understanding.

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“…Ces situations mobilisent les principes d'advocacy et de justice sociale, qui sont des éléments essentiels à la profession. Malgré leur importance, le sens profond de ces deux principes est actuellement débattu [2] et le risque de rupture identitaire en contexte médico-légal réaffirme l'exigence d'un tel débat. [9] L'advocacy réfère généralement à la défense des intérêts de l'usager et de son bien-être, à son accompagnement au sein du processus décisionnel, ainsi qu'au devoir de soin qui incombe aux infirmières à l'égard des besoins de ce dernier.…”

Section: Penser L'advocacy à Partir De La Justice Socialeunclassified

“…[9] L'advocacy réfère généralement à la défense des intérêts de l'usager et de son bien-être, à son accompagnement au sein du processus décisionnel, ainsi qu'au devoir de soin qui incombe aux infirmières à l'égard des besoins de ce dernier. [1,2] Certains auteurs soulignent l'ambiguïté du sens accordé à ce concept, notamment en raison de sa difficile confrontation à la culture institutionnelle et de la mince frontière séparant ce principe du paternalisme médical. [2] D'autres auteurs ont exposé l'intrication de cette notion au principe de justice sociale, ce qui permet à la pratique infirmière d'aller au-delà d'une approche strictement individuelle afin d'exposer les injustices structurelles pouvant affecter la santé et les droits des usagers.…”

Section: Penser L'advocacy à Partir De La Justice Socialeunclassified

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Untitled

Pariseau‐Legault¹

2017

aporia

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Patient advocacy by nurses – past, present and future

Abstract: This paper highlights the gap between the ideal of patient advocacy and the realities of everyday nursing practice. The responsibility for enacting advocacy sits with both individual practitioners and the organizations nurses work within.

Cited by 33 publications

References 74 publications

Speaking up about patient safety in psychiatric hospitals – a cross‐sectional survey study among healthcare staff

Speaking up about patient safety in psychiatric hospitals – a cross‐sectional survey study among healthcare staff

A Spider in a Broken Web: Nurses’ Views on Discharge Planning for Older Patients after Hip Fracture Surgery Who Live in their Own Homes in Rural Areas

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