No description available.

Trauma är den vanligaste dödsorsaken bland unga människor i Sverige. Omhändertagandet vid trauma präglas av effektivitet och tiden är dyrbar för att snabbt identifiera patientens skador och behov av fortsatta medicinska- och omvårdnadsåtgärder. Patienten som drabbas av trauma är i ett utsatt läge och sjuksköterskan får inte glömma bort dennes omvårdnadsbehov i en komplex situation. Hur patienten själv ser på omhändertagande vid trauma lägger grunden för bemötandet. Syftet var att beskriva traumapatienters upplevelser av bemötande och omhändertagande på akutmottagningen.Den metod som användes var en allmän litteraturöversikt för att svara på studiens syfte. Sökningar utfördes i databaserna PubMed, CINAHL, samt manuella sökningar. I översikten inkluderades 17 vetenskapliga originalartiklar efter kvalitetsgranskning, dessa var publicerade 2010–2020. En integrerad analys användes för att analysera och syntetisera de artiklar som inkluderades.I resultatet uppkom fyra huvudkategorier; patientens upplevelse av traumateamets omhändertagande, kommunikationens betydelse för patienten, att vara patient i en utsatt situation och patientens upplevelse av vårdpersonalens bemötande. Under huvudkategorierna framkom flera underkategorier. Avseende traumateamets omhändertagande handlade det både om tillfredsställelse och missnöje med insatsen. Betydelsen av kommunikationen för patienten kunde delas in i god kommunikation, icke verbal kommunikation och bristande kommunikation. Att vara patient i en utsatt situation handlade om patientens upplevelse i en skrämmande situation på akutmottagningen och hur patienten upplevde undersökningar och procedurer. I huvudkategorin patientens upplevelse av vårdpersonalens bemötande handlade det om personalens kompetens, patientens upplevelse av att bli respekterad och sedd samt att patienten ej kände förtroende för personalen. Slutsatsen av litteraturstudien var att kommunikationen har en särskild betydelse vid traumaomhändertagande på akutmottagningen. Kommunikationen är inte bara betydelsefull initialt vid undersökningen utan även vid procedurer som att informera om skador, prognos och behandling samt vid utskrivning och återhämtningsfasen. / Trauma is the most common cause of death among young people in Sweden. Care in the event of trauma is characterized by efficiency and time is precious to quickly identify patients´injuries and the need for medical treatment and nursing care. The patient who suffers from trauma is in a vulnerable situation and the nurses must not forget his or her needs for nursing care in a complex situation. How the patient himself views care in the event of trauma lays the foundation for the treatment. The purpose was to describe trauma patients’ experience of treatment and care in the emergency department.The method used to respond to the purpose of the study was a general literature review. Article searches were performed in the database PubMed, CINAHL and through manual searches. Seventeen empirical original articles were included in the literature review after a quality review, the articles were published between 2010-2020. An integrated analysis was used to analyze and synthesize the included articles. In the result, four main categories emerged; the patient's experience of the trauma team's care, the importance of communication to the patient, being a patient in a vulnerable situation and the patient's experience of the healthcare professionals treatment. Under the main categories, several subcategories emerged. Regarding the trauma team's care, it was both about satisfaction and dissatisfaction with the effort. The meaning of communication could be divided into good communication, non-verbal communication and lack of communication. Being a patient in a vulnerable situation was about the patient's feelings in a frightening situation in the emergency department and how the patient experienced examinations and procedures. In the main category, the patient's experience with healthcare professionals' reply, they talked about the staff's competence, the patient's experience of being respected and seen and that the patient felt confidence in healthcare professionals. In conclusion, communication has a special significance throughout trauma care in the emergency department, both initially at the examination and when procedures were done and when informing the patient about injuries, prognosis and treatment, as well as the discharge and recovery phase.

No description available.

Patient safety climate is defined as a holistic snapshot of enacted work environment practices and procedures related to patient safety, derived from shared perceptions of social and environmental work characteristics. While patient safety climate has been touted as a critical factor underlying safe patient care, our understanding of input factors influencing shared climate perceptions and, in turn, the effects of climate as a collective, group-level construct on important outcomes remains underdeveloped, both theoretically and empirically. Therefore, the current study examines (1) the antecedents that impact individual patient safety climate perceptions and (2) the relationships between hospital unit patient safety climate and two important unit level outcomes: patient willingness to recommend a facility to others and patient safety. This study also examines climate strength--the degree to which climate perceptions are shared--as a moderator of these relationships. While climate is conceptualized as a holistic description of the working environment, existing evidence has focused on relationships between the independent dimensions of patient safety climate and patient safety. No study to date has examined the configurations (i.e. patterns or profiles) among the multiple dimensions of patient safety climate or how these configurations are related to important employee and patient outcomes. This gap is redressed in the current study by examining patient safety climate in terms of three profile characteristics: (1) climate elevation (i.e., mean positive or negative valence across all dimensions), (2) climate variability (i.e., variance among dimensions), and (3) climate shape (i.e., the pattern of peaks and valleys among climate dimensions). Evidence from studies of general organizational climate suggests that the shape of the pattern among climate dimensions, the overall mean score across dimensions, and the degree to which dimension scores vary are predictive of employee attitudes, customer satisfaction, and organizational financial performance (Dickson et al., 2006; Joyce & Slocum, 1984; Jackofsky & Slocum, 1988; Gonzalez-Roma, Peiro, & Zornoza, 1999; Litwin & Stringer, 1968; Schulte et al., 2009). The current study, then, tests a theoretical model of patient safety climate examining the configural nature of the construct. An archival dataset collected from seven hospitals located in a metropolitan area of the southeastern United States was utilized to test study hypotheses. Data was collected from 3,149 individuals nested within 84 hospital units using the Hospital Survey on Patient Safety Culture (Sorra & Nieva, 2004). Unit level patient safety and patient willingness to recommend was collected by the hospital risk management and nursing administration departments. Hierarchical linear modeling (HLM7; Raudenbush, Bryk, Cheong, Congdon, & du Toit, 2011) was utilized to test hypotheses regarding antecedents of individual level perceptions of patient safety climate to account for the fact that individuals were nested within hospital units. Traditional multiple regression analyses were utilized to test unit level hypotheses examining the relationships between unit level patient safety climate and patient outcomes. Results indicated that unit membership was significantly related to individual climate perceptions--specifically, individual-level climate profile elevation. In turn, individual climate profile elevation and profile variability were related to employee willingness to recommend their organization to family and friends in need of care. At the unit level of analysis, climate profile variability was significantly related to patient willingness to recommend the organization to others, and climate shape was found to be related to patient safety. Furthermore, these results were not dependent on climate strength. The current study meaningfully contributes to the conceptual understanding of the patient safety climate construct by examining the degree to which configural aspects of the construct are predictive of important outcomes across multiple levels of analysis. In this way, it extends beyond existing studies of climate configurations to examine relationships at multiple levels of analysis and to also examine the moderating effects of climate strength. Practically, results provide insight into how the construct of patient safety climate can be used diagnostically and prescriptively to improve patient care and the working environment for providers. In addition to contributing to the theoretical understanding of the patient safety climate construct, this study also augments the evidence-base available to administrators, front-line providers, and regulators regarding how patient safety climate can be used to guide and align quality improvement efforts for greatest impact.

With healthcare organizations struggling to remain competitive and financially stable in a market where minimizing costs is a priority, hospital administrators feel the sense of urgency when it comes to keeping patients satisfied with services in order to expand volume and market share. The Emergency Department is considered the front door of a healthcare organization, and keeping its visitors satisfied in order to guarantee a future visit or a referral to a friend or family member is a must. While patient input on the services received in a healthcare facility is essential to improving quality of care, the costs associated with measuring, collecting and analyzing their feedback are remarkable. This research focuses on developing a linear regression model to predict patient satisfaction in the ED using surrogate measures related to patient's socio-demographic characteristics and visit characteristics. With a model of this kind, healthcare administrators can potentially eliminate survey costs while still being able to determine where the hospital stands in the eyes of the patient. Three modeling approaches were used to develop a multiple regression equation. Modeling approach 1 used monthly patient satisfaction scores as the dependent variable collected by a third-party survey organization. The goal of this model was to predict monthly patient satisfaction scores. Modeling approach 2 used patient satisfaction scores collected by the discharge registrar prior to the patient leaving the ED. The goal of this model was to predict patient satisfaction scores on a patient-by-patient basis. Modeling approach 3 used patient satisfaction scores collected by a third-party survey organization. The goal of this modeling approach was to predict patient satisfaction scores on a patient-by-patient basis. Each modeling approach developed in this study used its own survey tool. Though this study had limitations when it came to developing the models and validating the findings, results are very promising. Analysis shows that predicting average patient satisfaction scores on a monthly basis gives the most accurate results, with socio-demographic characteristics and visit characteristics explaining 96% of variation in monthly average patient satisfaction scores. Other model indicators, such as normality of residuals, predicted error, mean square error, and predicted R-square show that the model fits the data very well and has strong predictive ability. Models that attempted to predict patient satisfaction on a patient-by-patient basis appeared to be ineffective, with very large predicted errors and prediction intervals and low predictive ability.

Volunteers have been present in healthcare settings for centuries, however there is little empirical evidence supporting the impact that volunteers make on hospital performance. Since the 1990s, hospitals in the United States have had a great deal of pressure to produce high quality care at minimum expense. With the pressures of managed care and accrediting agencies, the benefits of using volunteers in a hospital setting are multiplied. Furthermore, as the population of the United States grows and the aging population creates more healthcare needs, the need for volunteers in hospitals may increase. This study utilized multiple regression analysis to explore the belief that the volunteer workforce is cost effective and can greatly enhance quality in a hospital setting. Hospitals throughout the state of Florida were invited to participate in the study by completing a brief questionnaire about their volunteer programs. Performance indicators of profit margin, volunteer cost savings, and patient satisfaction scores were analyzed using American Hospital Association and Agency for Health Care Administration data sets along with data obtained from the questionnaire. Results indicate that the use of volunteers offer significant cost savings to hospitals. Furthermore, the assignment of volunteers in patient settings can enhance a hospital's patient satisfaction scores. It also suggests that there is a need to further explore the impact of volunteers on other performance measures. Future research opportunities and policy recommendations are suggested.

Justice-involved youth have been shown to have higher rates of mental health concerns and trauma exposure than youth in the general population (e.g., Wood et al., 2002). An increased understanding of these mental health concerns is crucial as incarcerated youth already have worse long-term health outcomes (Barnert et al., 2017). However, while the mental health needs in terms of specific mental health diagnoses of justice-involved youth are well-documented (e.g., Teplin et al., 2002), there is a lack of research on the mental health services that are provided to justice-involved youth in institutional settings. Further, there is no known research on youth perceptions of the mental health services they received while incarcerated, which could be used to inform future research and practice to improve services. Thus, this study aimed to fill this gap by examining through a mixed-methods approach how justice-involved youth perceive the mental health care they received while incarcerated, as well as by exploring themes of areas of improvement that youth indicate as recommendations for better mental health support in youth justice institutional settings. Two-hundred and one (201) individuals who were formerly incarcerated as youth (age 24 or younger) participated in this study. Overall, participants indicated slightly greater than average satisfaction with the mental health care they received. Kruskal-Wallis tests were used to examine differences in satisfaction between groups. Significant differences in satisfaction among facility types that youth were incarcerated in and among racial groups were found. There were no significant differences based on gender or ethnicity. Multiple regression analyses were performed to examine the relationship between Type-T (risk-taking/thrill-seeking) personality and satisfaction of mental health services while incarcerated, while controlling for covariates (gender, race, ethnicity, facility type, mental health diagnoses, and mental health services). Type-T was not found to be a significant predictor of satisfaction. Some mental health diagnoses (e.g., post-traumatic stress disorder, autism spectrum disorder, schizophrenia/psychotic disorder, substance use disorder), some racial groups (e.g., Arab American/Middle Eastern compared to White), and some facility types (e.g., juvenile detention compared to prisons) were found to be significant predictors of satisfaction. Thematic analysis was also performed on qualitative information obtained from both the surveys and interviews. Themes identified for positive aspects of mental health care experiences include Impact of Services, Relationships, Access, Service Quality, and No Positives. Themes identified for negative aspects of mental health care experiences include Access, Service Quality, Lack of Comfort, Ineffectiveness, Low Social Support, Physical Environment, All Negative, and No Negatives. Themes identified for recommendations include Access, Service Quality, Physical Setting and Environment, and Social Support. Results from this study have the potential to be used to inform experimental evaluations of changes to mental health services for incarcerated youth based on the strengths, identified needs, and recommendations of current mental health care from this study. Such studies could be aimed at improving services for incarcerated youth and developing best practices for mental health services for this population. / Psychological Studies in Education

Effective patient-provider communication (PPC) involves conveying sufficient information to a patient such that the treatment is agreed upon and implemented accurately. Furthermore, a patient must feel adequately involved in the treatment process. With the advent of the COVID-19 pandemic, many clinical visits were shifted online. Although telemedicine was successful in meeting pandemic-specific goals, such as lowering personal contact, it changes the communicative context. Both patients and providers get less input from body language (nonverbal communication) and rely more on verbal communication. Furthermore, the number of telemedicine visits conducted remains elevated over pre-pandemic levels. Much of what is known about effective PPC is derived from studies in in-person contexts, with little information available in virtual contexts. Given that even occasional lapses in optimal PPC can have severe effects on patient outcomes, it is essential to understand PPC in various settings to optimize patient outcomes in the long run. This study was a secondary data analysis of the UCF Student Health Services Patient Satisfaction Questionnaire. A total of 6645 survey results from January 2021 to November 2022 were analyzed to compare patient perceptions of PPC variables and overall satisfaction with the clinical visit. The results indicated that there was no statistically significant difference in overall satisfaction and PPC variables between telemedicine and in-person visits. However, the results revealed that different PPC variables contributed to overall satisfaction with telemedicine and in-person visits. Keywords: patient-provider communication, telemedicine, telehealth, COVID-19, patient satisfaction, college

‎Nursing is a trusted profession aimed at delivering quality, patient-centered care perceived by patients as caring and satisfactory. While empiric care components are measurable as associated with clinical outcomes, patients’ perceptions of care are increasingly important in determining satisfaction with the patient care experience. Not clearly defined, nor empirically measurable, the “art” of nursing is taking on increasing importance as a component of satisfaction with the patient experience. The purpose of this integrative literature review was to review the literature in order to find common themes influencing determination of the art of nursing on patient satisfaction in acute care settings. Fourteen studies were selected and reviewed after a search of CINAHL Plus with Full Text, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, ERIC, MEDLINE, PsycARTICLES, and PsycINFOCINAHL databases. Four themes that emerged: building a relationship with the patient; conducting a thorough assessment of the patient; meaningful communication with the patient, and availability of nurses for their patients. The findings suggest that the art of nursing, as grounded in the demonstration of nursing care behaviors, is a component of patients’ satisfaction with the provision of care. This evidence-based knowledge is transferable to efforts in modifying nursing practices that exemplify patient-centered care.

The most important aspect of an encounter between a patient and his or her provider is the patient's ability to understand and implement the treatment plan and self-care instructions conferred by the provider. However, the literature in the field of patient-provider communication reveals that there is a noticeable gap in health literacy in certain patient populations that impairs their ability to understand pre-, during, and post-encounter paperwork, terminology, treatment plan, and critical self-care instructions. This has been shown to have detrimental consequences on patient health outcomes. The teach-back method, in which providers request patients to repeat key information discussed during the encounter in their own words, has been shown to successfully improve patient satisfaction, self-efficacy, and knowledge post-encounter. This paper seeks to investigate the impact of health literacy and teach-back on patient satisfaction, self-efficacy, and knowledge, and to determine the effect of a teach-back training intervention on the usage of teach-back during a patient-provider encounter. A total of 88 patients and 11 providers participated in this study over the course of two semesters. A pre- and post-encounter questionnaire was provided to patients and a post-encounter questionnaire to providers. Data regarding teach-back instances during the encounter were obtained via transcripts of encounter audio recordings. Training was given to 17 providers between semesters, 11 of whom were participating in a larger study data collection, and pre- and post-training teach-back instances were compared. The data were coded and statistically analyzed. The results were that there was a statistically significant relationship between health literacy and patient satisfaction as well as patient self-efficacy. Additionally, there was a significant relationship between teach-back and patient self-efficacy with an upward trend observed on the knowledge measures post-teach-back. Teach-back interventional training was also seen to have a statistically significant impact on provider use of teach-back during the patient encounter. Additional research in this field observing fidelity of teach-back practice and observing impacts of teach-back on a separate non-student population could be beneficial in improving patient encounters.