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Clinician-perceived barriers and facilitators for the provision of actionable processes of care important for persistent or chronic critical illness.
- Source :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.); Apr2024, Vol. 80 Issue 4, p1619-1629, 11p
- Publication Year :
- 2024
-
Abstract
- Aim: To explore clinician-perceived barriers to and facilitators for the provision of actionable processes of care important for patients with persistent or chronic critical illness. Design: Qualitative descriptive interview study. Methods: Secondary analysis of semi-structured telephone interviews (December 2018 – February 2019) with professionally diverse clinicians working with adults experiencing persistent or chronic critical illness in Canadian intensive care units. We used deductive content analysis informed by the Social-Ecological Model. Results: We recruited 31 participants from intensive care units across nine Canadian provinces. Reported intrapersonal level barriers to the provision of actionable processes of care included lack of training, negative emotions and challenges prioritizing these patients. Facilitators included establishment of positive relations and trust with patients and family. Interpersonal barriers included communication difficulties, limited access to physicians and conflict. Facilitators included communication support, time spent with the patient/family and conflict management. Institutional barriers comprised inappropriate care processes, inadequate resources and disruptive environmental conditions. Facilitators were regular team rounds, appropriate staffing and employment of a primary care (nurse and/or physician) model. Communitylevel barriers included inappropriate care location and insufficient transition support. Facilitators were accessed to alternate care sites/teams and to formalized transition support. Public policy-level barriers included inadequacy of formal education programs for the care of these patients; knowledge implementation for patient management was identified as a facilitator. Conclusion: Our results highlighted multilevel barriers and facilitators to the delivery of actionable processes important for quality care for patient/family experiencing persistent or chronic critical illness. Impact: Using the Social-Ecological Model, the results of this study provide intra and interpersonal, institutional, community and policy-level barriers to address and facilitators to harness to improve the care of patients/family experiencing persistent or chronic critical illness. Reporting Method: Consolidated criteria for reporting qualitative studies. [ABSTRACT FROM AUTHOR]
- Subjects :
- CHRONIC disease treatment
HEALTH services accessibility
COMMUNITY health services
HEALTH literacy
MEDICAL quality control
QUALITATIVE research
SECONDARY analysis
RESEARCH funding
PRIMARY health care
INTERVIEWING
CONTENT analysis
CATASTROPHIC illness
FAMILIES
TRANSITIONAL care
EXPERIENCE
ATTITUDES of medical personnel
RESEARCH
RESEARCH methodology
TELEPHONES
INTENSIVE care units
PHYSICIAN-patient relations
MATHEMATICAL models
INTERPERSONAL relations
THEORY
CONFLICT management
HEALTH care rationing
TRANSPORTATION of patients
SELF-perception
PROFESSIONAL competence
Subjects
Details
- Language :
- English
- ISSN :
- 03092402
- Volume :
- 80
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.)
- Publication Type :
- Academic Journal
- Accession number :
- 176848683
- Full Text :
- https://doi.org/10.1111/jan.15924