Sharing Lessons From Successes

Martin, Nicky; Frank, Barbara; Farrell, David M.; Brady, Cathie; Dixon-Hall, Janice; Mueller, Jessica; Rantz, Marilyn

doi:10.1097/ncq.0000000000000662

Cited by 4 publications

(10 citation statements)

References 17 publications

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“…Although the initial polices were adapted from hospital protocols, the nurses instituted practice within SHA that were beyond what was required by the NSW Health. This was in line with research reporting that in long term care facilities, nurse leaders who went above and beyond infection control guidelines had better staffing retention and commitment to the facility because the staff felt safe (Martin et al, 2023). In SHA, infection control measures such as the wearing of face masks were instituted when the facility opened but staff in hospitals were not required to wear masks by NSW Health until 24 July, 2020 (Trembath, 2020).…”

Section: Discussionsupporting

confidence: 77%

“…Although SHA always accepted patients from the community, the criteria for admission was expanded throughout the pandemic based on the increasing numbers of community based infections and people who could not effectively quarantine at home or had complex medical and social needs (Fotheringham et al, 2021). because the staff felt safe (Martin et al, 2023). In SHA, infection control measures such as the wearing of face masks were instituted when the facility opened but staff in hospitals were not required to wear masks by NSW Health until 24 July, 2020 (Trembath, 2020).…”

Section: Discussionmentioning

confidence: 99%

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“Their tenacity to just keep going”: Nurses' experiences in medical hotel quarantine during the COVID‐19 pandemic

Jefferies,

Ramjan,

Stanbrook

et al. 2023

Journal of Advanced Nursing

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AimTo explore how nurses and nursing knowledge contributed to the success of an Australian nurse‐led medical hotel quarantine facility during the COVID‐19 pandemic. The facility was established to accommodate returning travellers who were COVID‐19 positive or at risk of becoming positive, to travellers requiring complex care and expanded to community members who could not quarantine at home.DesignThis descriptive qualitative study explored how nurses and nursing knowledge in the quarantine facility contributed to the low transmission incidence of COVID‐19 infection.MethodTwelve semi‐structured interviews were conducted via ZOOM from February to May 2022 with all levels of nursing staff (nurse managers to assistants in nursing) who had worked in the facility for 3 months or more. The nurses were asked to describe their experiences, the challenges they faced and how they overcame them. The data were rich and were analysed using Braun and Clarke's six‐step thematic analysis.ResultsFour broad themes were generated demonstrating how nurses played a pivotal role in the success of the facility. First: nursing knowledge was evident through the development of policies, which minimized risks to nurses and patients. Second: a community of learning was developed as nurses supported upskilling and capacity building of staff, particularly new graduates with the facility. Third: a supportive management structure promoted teamwork and a positive workplace culture. And finally: the nurses were encouraged to develop techniques that promoted self‐care which enabled them to develop resilience.ConclusionThis was a nurse‐led service that developed strategies to manage care delivery and overcame unanticipated difficulties in a unique clinical setting.Reporting MethodThe quality of the research design was ensured by using the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist.Patient or Public ContributionNo patient or public contribution.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

“Their tenacity to just keep going”: Nurses' experiences in medical hotel quarantine during the COVID‐19 pandemic

Jefferies,

Ramjan,

Stanbrook

et al. 2023

Journal of Advanced Nursing

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“…With regard to leadership styles and staffing strategies in long‐term care facilities, exemplary leaders that stood out from their peers as “positive deviants” in their management of COVID‐19 infections were found to have employed the transformational leadership style, which encompasses characteristics such as team‐first attitudes, trusting, open communication, and a high tolerance for risk (Martin et al., 2023). The study also found that transformational leadership from managers had a positive impact on the implementation rates of prevention and control measures in nursing homes (Shi et al., 2021).…”

Section: Resultsmentioning

confidence: 99%

“…Exemplary leaders employed transformational leadership styles, which involved: (1) trusting and supportive relationships with employees; (2) positive presence and communication; and (3) consistent use of personnel (Martin et al, 2023).…”

Section: Extent Of Supervisor Support Management Modelmentioning

confidence: 99%

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Health and care workers in long‐term care facilities and their role in preventing emerging infectious diseases: A scoping review

Kung,

Fang,

Cheng

et al. 2023

J of Nursing Scholarship

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BackgroundThe COVID‐19 pandemic has had a tremendous impact on healthcare systems worldwide. In particular, long‐term care facilities have proved more susceptible to infection as they care for vulnerable populations at high risk of chronic illness. How this impacts the role and core competencies of health and care workers in these facilities remains less understood.AimDescribe how health and care workers contribute to the prevention of emerging infectious diseases in long‐term care facilities.DesignA scoping review.MethodsA systematic search of literature dating from 2002 to 2022 was conducted in the following databases: EMBASE, Medline (Ovid), Cochrane Library, CINAHL Plus with Full Text (EBSCOhost), Web of Science, and AgeLine. Studies were selected if they focused on health and care workers in long‐term care facilities, offered a perspective on the prevention of emerging infectious diseases or infection prevention and control, and were original qualitative or quantitative studies in English. Data were extracted, cross‐checked and analyzed by two researchers, and any difference in views regarding the appropriateness of literature would be resolved by consulting a third researcher. An inductive descriptive approach was applied for the analysis of results, and themes were established via consensus meetings.ResultsA total of fourteen studies from Asia, Europe, and the Americas were included. Three themes emerged from the review: “The roles of health and care workers evolve with the times”, “The core competencies of health and care workers are essential for preventing emerging infectious diseases in long‐term care facilities” and “The key to successful prevention of emerging infectious diseases in long‐term care facilities is through a systematic, comprehensive effort that mobilize health and care workers at all levels”. Health and care workers had to take on increasingly complex roles and rely on their core competencies to cope with epidemic changes, and facility resources, employee quality and management models were found to have significantly improved infection prevention and control outcomes.ConclusionsThe roles of health and care workers are evolving, and effective infection prevention within long‐term care facilities depends on their ability to perform core competencies with skill and confidence. Moreover, a systematic, comprehensive framework, for which this paper proposes three guidelines, is urgently needed to ensure consistent policy implementation within the facility as well as support and access to resources for health and care workers.Clinical RelevanceInfection prevention efforts within long‐term care facilities must take into account the evolving roles of health and care workers, with a focus on guaranteeing access to resources, training and support that will help them gain the core competencies necessary for juggling those roles. In addition, there is an urgent need for research instruments that will help assess those competencies and identify areas of improvement.

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The use of positive deviance approach to improve health service delivery and quality of care: a scoping review

Kassie,

Eakin,

Abate

et al. 2024

BMC Health Serv Res

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Background Quality has been a persistent challenge in the healthcare system, particularly in resource-limited settings. As a result, the utilization of innovative approaches is required to help countries in their efforts to enhance the quality of healthcare. The positive deviance (PD) approach is an innovative approach that can be utilized to improve healthcare quality. The approach assumes that solutions to problems are already available within the community and identifying and sharing those solutions can help others to resolve existing issues. Therefore, this scoping review aimed to synthesize the evidence regarding the use of the PD approach in healthcare system service delivery and quality improvement programs. Methods Articles were retrieved from six international databases. The last date for article search was June 02, 2023, and no date restriction was applied. All articles were assessed for inclusion through a title and/or abstract read. Then, articles that passed the title and abstract review were screened by reading their full texts. In case of duplication, only the full-text published articles were retained. A descriptive mapping and evidence synthesis was done to present data with the guide of the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews checklist and the results are presented in text, table, and figure formats. Results A total of 125 articles were included in this scoping review. More than half, 66 (52.8%), of the articles were from the United States, 11(8.8%) from multinational studies, 10 (8%) from Canada, 8 (6.4%) from the United Kingdom and the remaining, 30 (24%) are from other nations around the world. The scoping review indicates that several types of study designs can be applied in utilizing the PD approach for healthcare service and quality improvement programs. However, although validated performance measures are utilized to identify positive deviants (PDs) in many of the articles, some of the selection criteria utilized by authors lack clarity and are subject to potential bias. In addition, several limitations have been mentioned in the articles including issues in operationalizing PD, focus on leaders and senior managers and limited staff involvement, bias, lack of comparison, limited setting, and issues in generalizability/transferability of results from prospects perspective. Nevertheless, the limitations identified are potentially manageable and can be contextually resolved depending on the nature of the study. Furthermore, PD has been successfully employed in healthcare service and quality improvement programs including in increasing surgical care quality, hand hygiene practice, and reducing healthcare-associated infections. Conclusion The scoping review findings have indicated that healthcare systems have been able to enhance quality, reduce errors, and improve patient outcomes by identifying lessons from those who exhibit exceptional practices and implementing successful strategies in their practice. All the outcomes of PD-based research, however, are dependent on the first step of identifying true PDs. Hence, it is critical that PDs are identified using objective and validated measures of performance as failure to identify true PDs can subsequently lead to failure in identifying best practices for learning and dissemination to other contextually similar settings.

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Sharing Lessons From Successes

Cited by 4 publications

References 17 publications

“Their tenacity to just keep going”: Nurses' experiences in medical hotel quarantine during the COVID‐19 pandemic

“Their tenacity to just keep going”: Nurses' experiences in medical hotel quarantine during the COVID‐19 pandemic

Health and care workers in long‐term care facilities and their role in preventing emerging infectious diseases: A scoping review

The use of positive deviance approach to improve health service delivery and quality of care: a scoping review

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