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Aim Existing practice strategies for actively involving patients in care during hospitalisation are poorly understood. The aim of this study was to explore how healthcare professionals engaged patients in communication associated with care transitions. Method An instrumental, collective case study approach was used to generate empirical data about patient transitions in care. A purposive sample of key stakeholders representing (i) patients and their families; (ii) hospital discharge planning team members; and (iii) healthcare professionals was recruited in five Australian health services. Individual and group semi-structured interviews were conducted to elicit detailed explanations of patient engagement in transition planning. Interviews lasted between 30 and 60 minutes and were digitally recorded and transcribed verbatim. Data collection and analysis were conducted simultaneously and continued until saturation was achieved. Thematic analysis was undertaken. Results Five themes emerged as follows: (i) organisational commitment to patient engagement; (ii) the influence of hierarchical culture and professional norms on patient engagement; (iii) condoning individual healthcare professionals' orientations and actions; (iv) understanding and negotiating patient preferences; and (v) enacting information sharing and communication strategies. Most themes illustrated how patient engagement was enabled; however, barriers also existed. Conclusion Our findings show that strong organisational and professional commitment to patient-centred care throughout the organisation was a consistent feature of health services that actively engaged patients in clinical communication. Understanding patients' needs and preferences and having both formal and informal strategies to engage patients in clinical communication were important in how this involvement occurred. [ABSTRACT FROM AUTHOR]

Background The Advanced Life Support in Obstetrics ( ALSO) course is an internationally recognised interprofessional course to support health professionals to develop and maintain the knowledge and skills to manage obstetric emergencies. Aims This study investigated changes in confidence and perceived changes in the knowledge of doctors and midwives to manage specific obstetric emergency situations following completion of an ALSO course in Australia. Methods A prospective repeated-measures survey design was used to survey 165 course attendees from four Australian states pre- and postcourse and at six weeks ( n = 101). Data were analysed using a Friedman two-way repeated-measures analysis of variance and the Wilcoxon signed rank test. Results There was a significant improvement in confidence and perceived knowledge of the recommended management of all 17 emergency situations immediately postcourse ( P < 0.001) and at six weeks postcourse ( P < 0.001) when compared to precourse levels for both groups of health professionals. However, a significant decrease in knowledge and confidence for many emergency situations from immediately postcourse to six weeks postcourse ( P < 0.05) was also observed in both groups. Conclusions Completion of the Australian ALSO course in Australia has a positive effect on the confidence and perceived knowledge of doctors and midwives to manage obstetric emergencies. However, there needs to be some means of reinforcing the effects of the course for longer term maintenance of knowledge and confidence. [ABSTRACT FROM AUTHOR]

The article focuses on a study according to which whiteboards have the potential to improve patient flow, but a planned approach to their use is required.

Aim. To investigate general surgical patients’ perspectives of the adequacy and appropriateness of their discharge planning. Objectives. To identify any aspects of discharge planning that could be strengthened to assist people in managing their posthospital care and maintaining continuity of care. Background. Appropriate discharge planning is a priority in today's healthcare environment in which patients are discharged ‘quicker and sicker’, sometimes without home support. Adequate and appropriate discharge planning helps promote health literacy, which has benefits for both patients and their caregivers in helping them manage postsurgical recovery at home. Design. A qualitative, interpretive study was designed in which patients were interviewed at least one week after they returned home from hospital. Methods. Purposeful sampling was used to interview 13 general surgical patients from one of three hospitals (two public and one private) in New South Wales and Queensland, Australia. Data were collected in unstructured interviews and analysed using thematic analysis. Reflective analysis by individual research team members generated preliminary themes, which were then analysed collectively by all members of the research team to achieve consensus on patients’ perspectives. Results. Themes included a ‘one-size-fits-all’ approach to providing discharge information; inconsistent or variable advice from different health professionals; a lack of predischarge assessment of their home and/or work conditions and the need for follow-up assessment of patient and carer needs. Conclusions. The findings of this study illuminate the need for a more individualized approach to discharge planning, taking into account the patient's age, gender, surgical procedure and family and community support for immediate and longer-term nursing follow-up. Relevance to clinical practice. Patients would be more adequately prepared for their recovery period at home, by encouraging client-centred, interdisciplinary communication between health practitioners; adopting a flexible, approach to discharge planning which is tailored to individual needs of postsurgical patients, particularly in relation to advice and information related to recovery; and encouraging and supporting adequate health literacy for self-management. [ABSTRACT FROM AUTHOR]

Unlicensed assistive personnel in the critical care unit: What is their role? Driven by an economic imperative, the use of unlicensed assistive personnel (UAP) has proliferated in the health care system, however, their use in the critical care (CC) environment remains relatively new. An analysis of the first phase of a mixed method study, in which interviews with 17 CC nurses were conducted in order to provide data upon which to devise a larger survey, provides insight into the potential uses and misuses of these UAP. An examination of the transcripts, field notes, and diagrams and a comparison of the emerging categories to the literature assisted in identifying several themes important to CC nursing practice. Three themes identified in the analysis—ongoing vigilant assessment, quick response and seeing the whole picture—provide evidence that if UAP are asked to complete tasks allocated to them in other areas, CC nurses will be robbed of vital, albeit subtle, aspects of their nursing practice. As reflective practitioners, CC nurses must be wary of giving away tacit features of their role which enable them to synthesise contextual variables with espoused theory and experience, in order to ensure optimal patient care and outcomes. [ABSTRACT FROM AUTHOR]

Reports on the movement toward health care for all through community self-empowerment in the U.S. Role of nurses to devise strategies to mediate between people and their physical, cultural and social environment; Advancement of the professional image, status and credibility of nursing; Involvement in social and political advocacy. INSET: Health for All-Where are We Today?.