ORCID Profile
0000-0002-5691-2987
Current Organisations
WNSM
,
Swansea University
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Publisher: Springer Science and Business Media LLC
Date: 17-10-2012
Publisher: Wiley
Date: 02-09-2014
DOI: 10.1111/JOCN.12664
Abstract: This systematic review aims to synthesise the existing research on how patients participate in patient safety initiatives. Ambiguities remain about how patients participate in routine measures designed to promote patient safety. Systematic review using integrative methods. Electronic databases were searched using keywords describing patient involvement, nursing input and patient safety initiatives to retrieve empirical research published between 2007 and 2013. Findings were synthesized using the theoretical domains of Vincent's framework for analysing risk and safety in clinical practice: "patient", "healthcare provider", "task", "work environment", "organisation & management". We identified 17 empirical research papers: four qualitative, one mixed-method and 12 quantitative designs. All 17 papers indicated that patients can participate in safety initiatives. Improving patient participation in patient safety necessitates considering the patient as a person, the nurse as healthcare provider, the task of participation and the clinical environment. Patients' knowledge, health conditions, beliefs and experiences influence their decisions to engage in patient safety initiatives. An important component of the management of long-term conditions is to ensure that patients have sufficient knowledge to participate. Healthcare providers may need further professional development in patient education and patient care management to promote patient involvement in patient safety, and ensure that patients understand that they are 'allowed' to inform nurses of adverse events or errors. A healthcare system characterised by patient-centredness and mutual acknowledgement will support patient participation in safety practices. Further research is required to improve international knowledge of patient participation in patient safety in different disciplines, contexts and cultures. Patients have a significant role to play in enhancing their own safety while receiving hospital care. This review offers a framework for clinicians to develop comprehensive practical guidelines to support patient involvement in patient safety.
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.PMN.2014.09.006
Abstract: Nonpharmacologic pain management in patients receiving mechanical ventilation support in critical care units is under investigated. Natural sounds may help reduce the potentially harmful effects of anxiety and pain in hospitalized patients. The aim of this study was to examine the effect of pleasant, natural sounds on self-reported pain in patients receiving mechanical ventilation support, using a pragmatic parallel-arm, randomized controlled trial. The study was conducted in a general adult intensive care unit of a high-turnover teaching hospital, in Tehran, Iran. Between October 2011 and June 2012, we recruited 60 patients receiving mechanical ventilation support to the intervention (n = 30) and control arms (n = 30) of a pragmatic parallel-group, randomized controlled trial. Participants in both arms wore headphones for 90 minutes. Those in the intervention arm heard pleasant, natural sounds, whereas those in the control arm heard nothing. Outcome measures included the self-reported visual analog scale for pain at baseline 30, 60, and 90 minutes into the intervention and 30 minutes post-intervention. All patients approached agreed to participate. The trial arms were similar at baseline. Pain scores in the intervention arm fell and were significantly lower than in the control arm at each time point (p < .05). Administration of pleasant, natural sounds via headphones is a simple, safe, nonpharmacologic nursing intervention that may be used to allay pain for up to 120 minutes in patients receiving mechanical ventilation support.
Publisher: Hindawi Limited
Date: 14-10-2015
DOI: 10.1111/JONM.12338
Abstract: To explore the perspectives and experiences of nurse instructors and clinical nurses regarding the assessment of safe nursing care and its components in clinical practice. Safe nursing care is a key aspect of risk management in the healthcare system. The assessment of safe nursing care and identification of its components are primary steps to establish patient safety and risk management and enhance the quality of care in clinical practice. This was an interview study, with qualitative content analysis. Semi-structured interviews were conducted with 16 nurse instructors and clinical nurses including nurse managers chosen by purposive s ling based on theoretical saturation. Data collection and analysis were carried out simultaneously until data saturation was reached. Data analysis led to the extraction of four main themes: holistic assessment of safe nursing care team working and assessment of safe nursing care ethical issues and challenges of safe nursing care assessment. Identifying these four components in the assessment of safe nursing care offers a contribution to the understanding of the elements of safe care assessment and the potential for improved patient safety. Safe care management requires the accurate and reliable assessment of safe nursing care and the need for strategies for reporting actual or potential unsafe care and errors to ensure patient safety.
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.CTCP.2016.08.001
Abstract: This study aimed to investigate the impact of listening to pleasant natural sounds on anxiety and physiological parameters in patients undergoing coronary angiography. The present pragmatic quasi-randomized controlled clinical trial was conducted on 130 patients undergone elective angiography. The participants were randomly ided into two groups, including a pleasant natural sounds group, and a control group (n1/2 65 per group). Spielberger's state/trait anxiety inventory was used to assess levels of anxiety. The patients' anxiety level and physiological parameters were measured at baseline, before, during, immediately after, and 20 min after coronary angiography. The mean level of anxiety was similar in both arms at baseline (t = 1.317, df = 128, p = 0.190). The intervention arm displayed significantly lower anxiety levels than the control arm during the intervention (Wilks' lambda 0.11, Pillai's trace 0.89, P 0.001, F 2.05). The physiological parameters (systolic and diastolic blood pressure, mean arterial pressure, heart rate, and oxygen saturation) of both groups showed statistically significant differences (p < 0.05) over time and in group-by time interactions. As an effective nursing intervention presenting no side-effects, listening to pleasant natural sounds can be helpful in the management of anxiety.
Publisher: MDPI AG
Date: 26-10-2020
Abstract: Medicines management is a high-risk and error prone process in healthcare settings, where nurses play an important role to preserve patient safety. In order to create a safe healthcare environment, nurses should recognize challenges that they face in this process, understand factors leading to medication errors, identify errors and systematically address them to prevent their future occurrence. “Pro re nata” (PRN, as needed) medicine administration is a relatively neglected area of medicines management in nursing practice, yet has a high potential for medication errors. Currently, the international literature indicates a lack of knowledge of both the competencies required for PRN medicines management and the optimum educational strategies to prepare students for PRN medicines management. To address this deficiency in the literature, the authors have presented a discussion on nurses’ roles in medication safety and the significance and purpose of PRN medications, and suggest a model for preparing nursing students in safe PRN medicines management. The discussion takes into account patient participation and nurse competencies required to safeguard PRN medication practice, providing a background for further research on how to improve the safety of PRN medicines management in clinical practice.
Publisher: SAGE Publications
Date: 02-2016
Publisher: SAGE Publications
Date: 12-2015
Abstract: Assessment of quality of life is an important measure of the impact of disease and effectiveness of treatment. The Myocardial Infarction Dimensional Assessment Scale (MIDAS) is a disease-specific questionnaire developed for the evaluation of health-related quality of life in patients following myocardial infarction. The purpose of this study was to determine the psychometric properties of the Farsi version of MIDAS. The translated MIDAS was checked for validity and reliability with 350 patients who had suffered a myocardial infarction within the last 90 days. Participants were recruited from five inpatient wards and two outpatient departments at four university hospitals in Tehran between June 2013 and March 2014. Exploratory factor analysis indicated a six-factor solution for the questionnaire: ‘physical activity’, ‘insecurity’, ‘emotional reaction’, ‘dependency’, ‘diet’, and ‘concerns over medication and side effects’. Together, these accounted for 81.63% of variance observed. Cronbach’s alpha of the subscales ranged from 0.88 to 0.98, and test–retest reliability intraclass correlation coefficients ranged from .81 to .97, indicating that the instrument was reliable. The Farsi version of the MIDAS was reliable and valid for Iranian patients with myocardial infarction. The MIDAS can be used to measure health outcomes in different clinical settings and research centres, and by nurses for measuring health-related quality of life and determining the effects of medical and nursing interventions on patients’ quality of life.
Publisher: MDPI AG
Date: 13-01-2021
Abstract: Background and Objectives: There is a paucity of integrated knowledge regarding legal considerations required to ensure patient safety through safe medicines management. This study explores the legal considerations surrounding medicines management, providing a synthesis of existing knowledge. An integrative systematic review of the current international knowledge was performed. Materials and Methods: The search encompassed the online databases of PubMed (including Medline), Scopus, CINAHL, and Web of Science using MeSH terms and relevant keywords relating to the legal considerations of medicines management in healthcare settings. Results: The search process led to the identification of 6051 studies published between 2010 and 2020, of which six articles were found to be appropriate for data analysis and synthesis based on inclusion criteria. Research methods were varied and included qualitative interviews, mixed-methods designs, retrospective case reports and cross-sectional interrupted time-series analysis. Their foci were on the delegation of medicines management, pharmacovigilance and reporting of adverse drug reactions (ADRs) before and after legislation by nurses, physicians and pharmacists, medico-legal litigation, use of forced medication and the prescription monitoring program. Given the heterogenicity of the studies in terms of aims and research methods, a meta-analysis could not be performed and, therefore, our review findings are presented narratively under the categories of ‘healthcare providers’ education and monitoring tasks’, ‘in idual and shared responsibility’, and ‘patients’ rights’. Conclusion: This review identifies legal aspects surrounding medicines management, including supervision and monitoring of the effects of medicines healthcare providers’ knowledge and attitudes support and standardised tools for monitoring and reporting medicines’ adverse side effects/ADRs electronic health record systems in idual and shared perceptions of responsibility recognition of nurses’ roles detection of sentinel medication errors covert or non-voluntary administration of medication, and patient participation.
Publisher: Hindawi Limited
Date: 04-05-2016
DOI: 10.1111/JONM.12387
Abstract: This paper discusses the application of transformational leadership to the teaching and learning of safe medication management. The prevalence of adverse drug events (ADEs) and medication-related hospitalisations (one hundred thousand each year in the USA) are of concern. This discussion is based on a narrative literature review and scrutiny of international nursing research to synthesise pedagogical strategies for the application of transformational leadership to teaching medication safety. The four elements relating transformational leadership to medication safety education are: 'Idealised influence' or role modelling, both actual and exemplary, 'Inspirational motivation' providing students with commitment to medication safety, 'Intellectual stimulation' encouraging students to value improvement and change, and 'In idualised consideration' of in idual students' educational goals, practice development and patient outcomes. The model lends itself to experiential learning and a case-study approach to teaching, offering an opportunity to reduce nursing's theory-practice gap. Transformational leadership for medication safety education is characterised by a focus on the role of nurse educators and mentors in the development of students' abilities, creation of a supportive culture, and enhancement of students' creativity, motivation and ethical behaviour. This will prepare nursing graduates with the competencies necessary to be diligent about medication safety and the prevention of errors. Teaching medication safety through transformational leadership requires the close collaboration of educators, managers and policy makers. Investigation of strategies to reduced medication errors and consequent patient harm should include exploration of the application of transformational leadership to education and its impact on the number and severity of medication errors.
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.NEDT.2013.04.015
Abstract: Medication errors complicate up to half of inpatient stays and some have very serious consequences. To our knowledge, this is the first qualitative study of Iranian nursing students' perspectives of medication errors. To describe nursing students' perspectives of the causes of medication errors. Four focus groups were held with 24 nursing students from 4 different academic semesters in the nursing school in Tehran, between November 2011 and November 2012. Using a qualitative descriptive design, themes and subthemes were identified by content analysis. Two main themes emerged from the data: "under-developed caring skills in medication management" and "unfinished learning of safe medication management", which was sub ided into "drifting between being worried and being careful", and "contextualising pharmacology education". All respondents felt that their education programmes were leaving them vulnerable to "drug errors" and cited incidents where patient safety had been jeopardised. Nursing curricula need to increase investment in medicines management. If nursing students are to become competent, skilful and safe practitioners, their learning will require extensive support from their academic institutions and clinical mentors.
Publisher: MDPI AG
Date: 19-10-2020
DOI: 10.3390/GERIATRICS5040079
Abstract: Advances in medicines have increased the effectiveness of treatments and the social and cultural authority of doctors. However, as prescribing has become the dominant modality of treatment, the “pharmaceuticalization” of medical practice has often resulted in treatment “at a distance”, with doctors having limited contact with patients. Older and poorer people, who are socially distanced from medical prescribers, suffer more adverse drug reactions (ADRs) than the general population. A team approach to checking patients systematically for ADRs, as detailed in manufacturers’ literature, can minimise medication errors, but regular review is rare. This paper explains the benefits of medicines monitoring to protect older patients from iatrogenic harm, such as over-sedation, falls, or drug-induced Parkinsonism. We show how multidisciplinary initiatives to optimise prescribing can be supported by using a recognised resource—the adverse drug reaction profile (ADRe). The profile identifies and documents patients’ signs and symptoms of putative ADRs. Better monitoring allows professionals to adjust prescribing and respond to identified problems with agility. Implementation of systematic monitoring will require changes to the regulatory regime and better inter-professional cooperation. Providing carers, nurses and pharmacists with a structured system to monitor patients would democratise relevant medical knowledge and help address ageism and the socio-economic health ide.
Publisher: Wiley
Date: 09-11-2015
DOI: 10.1111/JAN.12848
Abstract: The aim of this study was to explore and compare the experiences of nurses in Australia and the UK as they moved from clinical practice into higher education institutions. When nurse education moved from hospitals into higher education institutions, the roles and career pathways of nurse educators changed. The design method used in this study was qualitative interview study. Semi-structured interviews were undertaken with 14 nurse educators, seven in Australia and seven in the UK, in 2011-2012. Thematic analysis of the transcripts was undertaken and triangulated with automated content and thematic analysis by Leximancer© software. Nurse academics in Australia and the UK voiced similar enthusiasms and concerns. These coalesced around four emergent themes: adapting to change, external pressures, teaching and progress up the academic ladder. The Leximancer© analysis for both sites ranked 'research' as the primary theme, linked with 'time', 'University' and 'nursing' on both sites. Respondents were aware of the importance of research to career progression in universities, but most prioritized their teaching and clinical commitments for the sake of their organizations. Most respondents were supported in their doctoral studies, but the absence of postdoctoral research teams, mentors and role models was striking. Additional support is needed to ensure that nurse academics are able to pursue research beyond doctoral level.
Location: United Kingdom of Great Britain and Northern Ireland
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