View clinical trials related to Nurse-Patient Relations.
Filter by:To determine whether implementation of Rehab MATRIX will improve patient safety, patient satisfaction and nursing indices.
These days, particularly over the last decade, attention is being paid to the opinion of the patient and, in the case of pediatrics, the patient's family. Unfortunately, recent work has shown that this remains an imperfect process. Studies of inpatient families show that parents often leave hospital with only a minimal idea of side effects of drugs, who they can contact in the event that something goes wrong, and even something as simple as the date of the next medical visit. In fact, some studies have shown that adult patients don't even know the name of their doctor or nurse. While there are several papers examining the degree of unhappiness of parents in hospitals, there is very little research looking at what can be done to improve a patient's sense of satisfaction with care (and communication) while in the hospital. One suggestion has been the provision of whiteboards in the room that can allow the family to have a better idea of what is going on during the child's day. These have been suggested but never exposed to prospective, quantitative study. With the intention of improving the management of patients in the new Acute Care Centre, the department of strategic planning at Children's Hospital organized a three day IMPROVE session moderated by PHSA specialists in quality control. During this meeting, the clinical course of a child on the medical and surgical wards was mapped out. This allowed the group to examine various ideas aimed at improving the care of children passing through the hospital and the sense of parental satisfaction with the whole process. The main conclusion from the meeting (based both on available literature and the clinical experience of the group), was that communication between the medical team and parents should be improved. It was also concluded that the best way to do this would be to have a regularly updated whiteboard in each room. Prior to starting this, it was generally felt that the introduction of whiteboards should be tested in a prospective controlled manner - starting with a baseline study of patient satisfaction.
Professional therapeutic boundaries are defined as the limits that protect the space between a professional's power and patient's vulnerability. It is important to develop therapeutic alliances while maintaining boundaries, thus ensuring nurses develop safe connections with patients and their families based on therapeutic needs. Due to the professional nature of nursing, boundary violations are common. For example, closeness and familiarity develops between the healthcare provider, patient, and caregiver that encompass the physical, emotional, and spiritual realms. This provides an opportunity for intense bonds with patients and families. Furthermore in oncology healthcare, providers deliver compassionate care and empathize with patients and families while sharing in the patient's illness journey. As a result of these bonds and relationships the nurse may over disclose personal information, provide excessive patient attention, meeting their own personal needs instead of the patient and family. In addition, continuity of care contributes to boundary crossings because there is frequent repeated contact with the same patients and families which allows blurring of boundary lines. When staff spend weeks, months, or even years with the same patient the opportunity to connect and talk about personal life details exist. At the national level, the National Council of State Boards of Nursing (NCSBN) has created materials for educating nurses in maintenance of therapeutic boundaries. Adherence to therapeutic boundaries has now become an education objective, with the development of educational interventions within many health care settings. Likewise, St. Jude nurses are at an increased risk of crossing therapeutic boundaries due to long term care relationships and vulnerable family members. However, nursing administration has not formally assessed the attributes or behaviors of the nursing staff. This proposal will describe the attributes and behaviors of the St. Jude staff nurse towards nurse-patient/family boundaries, providing knowledge to nursing leadership that will facilitate therapeutic boundaries focus groups with direct care nurses.