Exploring Person- Centredness in the Emergency Department
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Transcript of Exploring Person- Centredness in the Emergency Department
Exploring Person-Centredness in the
Emergency Department
Donna McConnell PhD Student
Prof Tanya McCance
Dr Vidar Melby
Dr Paul Slater (adviser)
Person-Centred Practice Framework(McCormack & McCance 2010)
Person-centred practice has shown to transform practices for patients...
• increased choice and involvement in decision making
• improved quality of nurse/patient engagements
• staff taking time to get to ‘know’ the person in a more meaningful way
• staff were more person-centred, in their language and team-work
• a reduction in ritual and routine
....and staff
• a shift in values to appreciate caring over the technical aspects of nursing care
• increased effectiveness of teamwork and workload management
• improved staff relationships with more effective collaborative working
• increased personal and professional job satisfaction - less intention to leave posts
• a more effective use of resourcesMcCormack et al (2010)
Themes from the literature• There is a distinct culture within EDs• The nature of ED work – saving lives, a medical-
technical environment where technology, medical status and patient throughput is valued over caring
• A culture of worthiness – appropriate pts for ED and the place of those who did not fit in with this
• Staff experience of working in ED• A stressful environment • Violence and aggression• Managing the patient journey – high responsibility,
low power
Themes from the literature• Fragmented care• Lack of privacy• A feeling of not being considered as an
individual and a lack of caring • Feeling abandoned, exposed, vulnerable,
ashamed, ignored, insecure, frightened forgotten or unwelcome
• Worse for vulnerable groups - older people, those with mental health issues and those at end of life
Aim
To explore person-centred practice within the ED environment.
• 2 stages
• Stage 1• Staff
questionnaire
• Stage 2
• Staff interviews
• Patient interviews
Methodology
Data collection
• Pilot study undertaken in August 2013
• Stage 1 - 714 questionnaires distributed to nursing and medical staff in 11 EDs in all 5 trusts in NI during March and April 2014
• Reminder letters sent
• Questionnaires returned 317 (44%)
• Effective responses 294 (41%)
Missing data n=13
Staff responded neutrally indicating that they neither agreed nor disagreed that they worked in a care environment
conducive to person-centred practice
Total mean score = 3.5(1 = Strongly Disagree to 5 = Strongly Agree)
Items comprising Supportive Organisational Systems scale
1 = Strongly Disagree to 5 = Strongly Agree
My team take time to celebrate achievements. 2.4
My organisation recognises and rewards success. 2.4
I am recognised for the contribution that I make to people having a good experience of care. 3.0
I am supported to express concerns about an aspect of care. 3.2
I have the opportunity to discuss my practice and professional development on a regular basis. 2.7
Staff agreed that they engaged in the necessary care processes to deliver person-centred practice
Total mean score = 4(1 = Strongly Disagree to 5 = Strongly Agree)