Barriers to ethical nursing practice for older adults in long‐term care facilities

Choe, Kwisoon; Kang, Hyun-Wook; Lee, Aekyung

doi:10.1111/jocn.14128

Cited by 14 publications

(25 citation statements)

References 43 publications

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“…Nurse leaders were recognized as having crucial roles in how reported incidents were processed and used for improving patient safety in residential long-term care settings. Generally, nurse leaders are responsible for encouraging error disclosure through policy making, creation of a supportive culture, and encouraging nurses to consider ethical values via provision of care, education, and mentorship [37,68,69]. Alleviation of moral distress after making errors, following up by apologizing to patients and their families [70], standardized tools and feedback [71,72], training regarding communication skills, and coping strategies to reduce nurses' emotional stress [37,73] are considered key leadership roles for nurses.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, nurse leaders are responsible for encouraging error disclosure through policy making, creation of a supportive culture, and encouraging nurses to consider ethical values via provision of care, education, and mentorship [37,68,69]. Alleviation of moral distress after making errors, following up by apologizing to patients and their families [70], standardized tools and feedback [71,72], training regarding communication skills, and coping strategies to reduce nurses' emotional stress [37,73] are considered key leadership roles for nurses. Systematic, in-built support for error identification [19,20] and disclosure should remove the responsibility to inform patients and their families from individual nurses [59].…”

Section: Discussionmentioning

confidence: 99%

“…They are best placed to identify adverse events in the process of care, due to their central role in the provision of care, along with their holistic knowledge of the patient [34,35]. They are more likely to report errors via error-reporting systems than other healthcare staff [36], attributed to their feeling of a moral obligation to provide safe care to patients [12,37,38].…”

Section: Introductionmentioning

confidence: 99%

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Disclosing and Reporting Practice Errors by Nurses in Residential Long-Term Care Settings: A Systematic Review

et al. 2020

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Patient safety is crucial for the sustainability of the healthcare system. However, this may be jeopardized by the high prevalence of practice errors, particularly in residential long-term care. Development of improvement initiatives depends on full reporting and disclosure of practice errors. This systematic review aimed to understand factors that influence disclosing and reporting practice errors by nurses in residential long-term care settings. A systematic review using an integrative design was conducted. Electronic databases including PubMed (including Medline), Scopus, CINAHL, Embase, and Nordic and Spanish databases were searched using keywords relating to reporting and disclosing practice errors by nurses in residential long-term care facilities to retrieve articles published between 2010 and 2019. The search identified five articles, including a survey, a prospective cohort, one mixed-methods and two qualitative studies. The review findings were presented under the categories of the theoretical domains of Vincent’s framework for analyzing risk and safety in clinical practice: ‘patient’, ‘healthcare provider’, ‘task’, ‘work environment’, and ‘organisation & management’. The review findings highlighted the roles of older people and their families, nurses’ individual responsibilities, knowledge and collaboration, workplace atmosphere, and support by nurse leaders for reporting and disclosing practice errors, which had implications for improving the quality of healthcare services in residential long-term care settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Disclosing and Reporting Practice Errors by Nurses in Residential Long-Term Care Settings: A Systematic Review

et al. 2020

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“…Long-term care facilities (LTCFs) are defined as institutions that provide services for patients who do not need acute treatment in a hospital but require long-term daily assistance [1234]. Many private and government institutions offering long-term health-care services have opened in Taiwan to serve the rapidly aging population.…”

Section: Introductionmentioning

confidence: 99%

Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus in long-term care facilities in eastern Taiwan

et al. 2019

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Objective:The prevention of infections is crucial in long-term care programs. Investigations of the occurrence and sources of pathogens in long-term care facilities (LTCFs) are still lacking, especially in eastern Taiwan. In this study, we conducted a surveillance of two common pathogens, Acinetobacter baumannii (AB) and methicillin-resistant Staphylococcus aureus (MRSA), in LTCFs in Hualien.Materials and Methods:Pathogenic assays including isolation, identification, and antimicrobial susceptibility tests were conducted for AB and MRSA at LTCFs in Eastern Taiwan. Staphylococcal cassette chromosome mec typing assays were done to understand the relatedness of clonal strains of MRSA.Results:All AB-positive samples in the LTCFs were mainly from water-rich samples and were drug susceptible. Our data indicated that the AB strains from LTCFs were similar to those from Puzi River watersheds in Taiwan, which were not drug resistant to commonly used antibiotics. On the other hand, the drug resistance analysis of MRSA indicated that the genotypes from the LTCFs were similar to those from nearby hospitals. Eight strains of MRSA were isolated from four LTCFs, of which five were identified as hospital-acquired strains according to SSCmed typing assays.Conclusion:These findings suggest that MRSA in LTCFs might propagate from hospitals and could be transmitted between hospitals and LTCFs. Health authorities should be aware of this risk. The long-term follow-up of MRSA is recommended in local medical institutions as well as in LTCFs for correlative analysis.

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“…professional reputation [28]. nurse leaders are responsible for encouraging error disclosure through policy making, creation of a supportive culture, and encouraging nurses to consider ethical values via provision of care, education, and mentorship [33]. It should be noted that by converting negative feedback into positive feedback, it is possible to provide the basis for voluntary error reporting by medical care staff.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Reporting Clinical Errors in Operating Theatres and Intensive Care Units of a Teaching Hospital: A Phenomenological Study

Ghobadian¹,

Zahiri²,

Dindamal³

et al. 2021

Preprint

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Background: Clinical errors are one of the challenges of health care in countries; moreover, the obtaining of accurate statistics regarding clinical errors in most countries is a difficult process and varies from one study to another. The current study was conducted to identify impediments in the reporting of clinical errors in the operating theatre and the intensive care unit of a teaching hospital.Methods This study was conducted qualitatively in the operating theatre and intensive care sections of a training hospital. Data collection was conducted through semi-structured with medical care staff and senior doctors and surgical assistants. Data analysis was carried out through listening to recorded interviews and developing tape scripts of the interviews. The meaning units were identified and codified based on the type of discussion. Furthermore, codes which had a common concept were categorized in one group and by using the designated groups, the main problems were derived. Finally, the codes and designated groups were analyzed, discussed and confirmed by a panel of four experts in qualitative content, and the existing main problems were identified and categorized.Results: Barriers to reporting clinical errors were extracted in two themes: individual and organizational problems. Individual problems included 4 categories and 12 codes and organizational problems included 6 categories and 17 codes. The results showed that in the majority of cases, nurses indicated their desire to change current prevailing attitudes in the workplace while doctors expected reform policies dealing with clinical errors in teaching hospitals to be implemented at higher levels by officials. Conclusion: in order to alleviate Barriers to reporting clinical errors, individual problems and organizational problems should be resolved. To reduce individual problems, it is recommended to train the nursing and medical team in the field of error recognition. In order to solve organizational problems in the nursing team, improve the process of reporting clinical errors and in the medical team, rectifying of legal loopholes should be considered.

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Barriers to ethical nursing practice for older adults in long‐term care facilities

Abstract: Support programmes and educational opportunities are needed for nurses who experience emotional distress and lack of competency to strengthen their resilience towards some of the negative aspects of care and being a nurse that were identified in this study.

Cited by 14 publications

References 43 publications

Disclosing and Reporting Practice Errors by Nurses in Residential Long-Term Care Settings: A Systematic Review

Disclosing and Reporting Practice Errors by Nurses in Residential Long-Term Care Settings: A Systematic Review

Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus in long-term care facilities in eastern Taiwan

Barriers to Reporting Clinical Errors in Operating Theatres and Intensive Care Units of a Teaching Hospital: A Phenomenological Study

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