Lc Hemmings

Lost in translation: Maximizing handover effectiveness between paramedics and receiving staff in the emergency department

Objective:  The purpose of the present study is to investigate perceptions by paramedics and hospital receiving staff about what enables and constrains handover in the ED.

Seeking respite: issues around the use of day respite care for the carers of people with dementia

ABSTRACT Ageing in Place policies have transferred responsibility for many frail elderly people and those living with dementia from residential to in-home care. Despite this placing a greater obligation on families, in Australia carers continue to under-use day respite services. This qualitative design study identified issues around the use of day respite care from the perspective of the family carer, focusing on barriers to attendance and strategies to facilitate attendance. Telephone interviews were held in 2007 with Tasmanian carers whose family member refused to attend day respite care (ten carers) and those whose family member attended (17). Carers considering day respite care were often overwhelmed by the quantity of information, confused about the process, and worried about the recipients safety in an unfamiliar environment. They felt anxious about public acknowledgement of the condition leading to fear of embarrassment. Day respite care users appreciated the break it provided them and the opportunity for their family member to socialise. To facilitate a greater uptake of day respite care, reliable information sources and strategies to help carers deal with the emotions they face on a daily basis, together with a wider social acceptance of dementia, are important. Furthermore, carers need an opportunity to talk with others, enabling them to gain support from those who have successfully introduced a family member to day respite care.

Hand hygiene compliance: the elephant in the room

Abstract Introduction Hand hygiene compliance rates for medical staff are consistently lower than those for nurses. Strong leadership to improve compliance has been repeatedly called for, but studies exploring medical staff leadership influence are limited. The qualitative study reported here aimed to explore the perceptions that medical staff have of their clinical leaders and the extent to which they influence hand hygiene practice in their clinical units, and to compare this with unit specific compliance data. Method Thirty junior doctors from a major tertiary hospital were interviewed or surveyed to uncover their perceptions of clinical leadership and its influence on hand hygiene behaviours. Compliance data for their clinical areas for the corresponding period was obtained and compared with their views on the influence of leadership on hand hygiene behaviour. Findings Consultants, rather than infection control nurses, were seen to have the most influence over medical hand hygiene practices. The unit that scored the best on compliance was also the one where the consultant was perceived to have the most influence. Conclusion Junior medical staff know that hand hygiene is important but the extent to which they comply with it depends on the influence of the consultant. Infection control staff need to engage consultants in order to improve medical compliance rates, rather than directing their efforts to medical staff in general.

Clinical leadership style and hand hygiene compliance

Purpose – The purpose of this paper is to investigate to what extent an engaging or authentic leadership style is related to higher levels of patient safety performance. Design/methodology/approach – A survey and/or interview of 53 medical and dental staff on their perceptions of leadership style in their unit was conducted. Scores obtained from 51 responses were averaged for each question and overall performance was compared with unit specific hand hygiene (HH) compliance data. Interview material was transcribed and analysed independently by each member of the research team. Findings – A modest negative relationship between this leadership style and hand hygiene compliance rates (r=0.37) was found. Interview data revealed that environmental factors, role modelling by the leader and education to counter false beliefs about hand hygiene and infection control may be more important determinants of patient safety performance in this regard than actual overall leadership style. Research limitations/implication...