2 results
Experiences of security and continuity of care: Patients' and families' narratives about the work of specialized palliative home care teams
- Anna Klarare, Birgit H Rasmussen, Bjöörn Fossum, Carl Johan Fürst, Johan Hansson, Carina Lundh Hagelin
-
- Journal:
- Palliative & Supportive Care / Volume 15 / Issue 2 / April 2017
- Published online by Cambridge University Press:
- 22 July 2016, pp. 181-189
-
- Article
- Export citation
-
Background:
Those who are seriously ill and facing death are often living with physical, emotional, social, and spiritual suffering. Teamwork is considered to be necessary to holistically meet the diverse needs of patients in palliative care. Reviews of studies regarding palliative care team outcomes have concluded that teams provide benefits, especially regarding pain and symptom management. Much of the research concerning palliative care teams has been performed from the perspective of the service providers and has less often focused on patients' and families' experiences of care.
Objective:Our aim was to investigate how the team's work is manifested in care episodes narrated by patients and families in specialized palliative home care (SPHC).
Method:A total of 13 interviews were conducted with patients and families receiving specialized home care. Six patients and seven family members were recruited through SPHC team leaders. Interviews were transcribed verbatim and the transcripts qualitatively analyzed into themes.
Results:Two themes were constructed through thematic analysis: (1) security (“They are always available,” “I get the help I need quickly”); and (2) continuity of care (“They know me/us, our whole situation and they really care”). Of the 74 care episodes, 50 were descriptions of regularly scheduled visits, while 24 related to acute care visits and/or interventions.
Significance of results:Patients' and family members' descriptions of the work of SPHC teams are conceptualized through experiences of security and continuity of care. Experiences of security are fostered through the 24/7 availability of the team, sensitivity and flexibility in meeting patients' and families' needs, and practical adjustments to enable care at home. Experiences of continuity of care are fostered through the team's collective approach, where the individual team member knows the patients and family members, including their whole situation, and cares about the little things in life as well as caring for the family unit.
Attitudes Towards and Experience of the Use of Triage Tags in Major Incidents: A Mixed Method Study
- Monica Rådestad, Kristina Lennquist Montán, Anders Rüter, Maaret Castrén, Leif Svensson, Dan Gryth, Bjöörn Fossum
-
- Journal:
- Prehospital and Disaster Medicine / Volume 31 / Issue 4 / August 2016
- Published online by Cambridge University Press:
- 23 May 2016, pp. 376-385
- Print publication:
- August 2016
-
- Article
- Export citation
-
Introduction
Disaster triage is the allocation of limited medical resources in order to optimize patient outcome. There are several studies showing the poor use of triage tagging, but there are few studies that have investigated the reasons behind this. The aim of this study was to explore ambulance personnel attitude towards, and experiences of, practicing triage tagging during day-to-day management of trauma patients, as well as in major incidents (MIs).
MethodsA mixed method design was used. The first part of the study was in the form of a web-survey of attitudes answered by ambulance personnel. The question explored was: Is it likely that systems that are not used in everyday practice will be used during MIs? Two identical web-based surveys were conducted, before and after implementing a new strategy for triage tagging. This strategy consisted of a time-limited triage routine where ambulance services assigned triage category and applied triage tags in day-to-day trauma incidents in order to improve field triage. The second part comprised three focus group interviews (FGIs) in order to provide a deeper insight into the attitudes towards, and experience of, the use of triage tags. Data were analyzed using qualitative content analysis.
ResultsThe overall finding was the need for daily routine when failure in practice. Analysis of the web-survey revealed three changes: ambulance personnel were more prone to use tags in minor accidents, the sort scoring system was considered to be more valuable, but it also was more time consuming after the intervention. In the analysis of FGIs, four categories emerged that describe the construction of the overall category: perceived usability, daily routine, documentation, and need for organizational strategies.
ConclusionTriage is part of the foundation of ambulance skills, but even so, ambulance personnel seldom use this in routine practice. They fully understand the benefit of accurate triage decisions, and also that the use of a triage algorithm and color coded tags is intended to make it easier and more secure to perform triage. However, despite the knowledge and understanding of these benefits, sparse incidents and infrequent exercises lead to ambulance personnel’s uncertainty concerning the use of triage tagging during a MI and will therefore, most likely, avoid using them.
,Rådestad M ,Lennquist Montán K ,Rüter A ,Castrén M ,Svensson L ,Gryth D .Fossum B Attitudes Towards and Experience of the Use of Triage Tags in Major Incidents: A Mixed Method Study . Prehosp Disaster Med.2016 ;31 (4 ):376 –385 .