ABSTRACT
BACKGROUND AND OBJECTIVES: There is increasing emphasis on the importance of patient and family engagement for improving patient safety. Our purpose in this study was to understand health care team perspectives on parent-provider safety partnerships for hospitalized US children to complement a parallel study of parent perspectives. METHODS: Our research team, including a family advisor, conducted semistructured interviews and focus groups of a purposive sample of 20 inpatient pediatric providers (nurses, patient care technicians, physicians) in an acute-care pediatric unit at a US urban tertiary hospital. We used a constant comparison technique and qualitative thematic content analysis. RESULTS: Themes emerged from providers on facilitators, barriers, and role negotiation and/or balancing interpersonal interactions in parent-provider safety partnership. Facilitators included the following: (1) mutual respect of roles, (2) parent advocacy and rule-following, and (3) provider quality care, empathetic adaptability, and transparent communication of expectations. Barriers included the following: (1) lack of respect, (2) differences in parent versus provider risk perception and parent lack of availability, and (3) provider medical errors and inconsistent communication, lack of engagement skills and time, and fear of overwhelming information. Providers described themes related to balancing parent advocacy with clinician's expertise, a provider's personal response to challenges to the professional role, and parents balancing relationship building with escalating safety concerns. CONCLUSIONS: To keep children safe in the hospital, providers balance perceived challenges to their personal and professional roles continuously in interpersonal interactions, paralleling parent concerns about role ambiguity and trust. Understanding these shared barriers to and facilitators of parent-provider safety partnerships can inform system design, parent education, and professional training.
Subject(s)
Child, Hospitalized/statistics & numerical data , Parents , Patient Safety/standards , Quality Improvement , Quality of Health Care/standards , Adult , Child , Female , Focus Groups , Health Services Research , Humans , Male , Professional-Family Relations , Qualitative ResearchABSTRACT
This study explored parents' perspectives regarding their involvement in safety for their hospitalized children. We employed qualitative description and semistructured interviews of parents of children in an urban tertiary hospital ward. Content analysis revealed 4 parent themes: risks to child safety and comfort, hospital role as a protector, participation in safety varies by individual and organizational factors, and balancing safety with "speaking up" interpersonal risks. We suggest key concepts to incorporate into staff education and family engagement/safety programs to develop effective partnerships between clinicians and parents.
Subject(s)
Child, Hospitalized , Parents/psychology , Patient Safety/standards , Perception , Child , Child, Preschool , Female , Hospitals/standards , Humans , Male , Pediatrics/methods , Pediatrics/standards , Qualitative ResearchABSTRACT
This third article in a series on the critical issue of the transition from pediatric to adult care for young adults with complex chronic conditions offers resources, including information about exemplary programs, to pediatric nurses. Three hospital-based programs are highlighted, four key Internet resources are identified, and five relevant articles are annotated. This information can support pediatric nurses in considering transition support options for individual teens and their families as well as in developing resources and designing programs in their own settings.
Subject(s)
Adolescent Health Services/organization & administration , Health Resources , Transition to Adult Care/organization & administration , Adolescent , Adult , Attitude to Health , Chronic Disease , Family , Female , Humans , Male , Young AdultABSTRACT
This article is the second in a series addressing the critical issue of the transition from pediatric to adult care for young adults with complex chronic conditions. Using the analogy of her daughter's recent transition from high school to college, the author highlights some of the needs of young adults and their families in a transition process. Then, drawing upon her years of experience in the field, she explains why the core principles of patient- and family-centered care are foundational to successful transitioning from pediatric to adult health care.
Subject(s)
Adolescent Health Services/organization & administration , Continuity of Patient Care/organization & administration , Family Nursing/organization & administration , Patient-Centered Care/organization & administration , Student Health Services/organization & administration , Transition to Adult Care/organization & administration , Adolescent , Adult , Child , Female , Humans , Male , Professional-Family Relations , United States , Young AdultABSTRACT
The development of trusting, caring, boundaried, mutual relationships between staff, patients, and families in health care settings demands a set of staff skills that reflect an understanding of the perspective of patient/family as well as one's colleagues. When nurse leaders collaborate with families in teaching nurses, they offer a powerful means of gaining an understanding of the complexities inherent in the health care partnership. This shared nurse leader/family approach to education provides an opportunity to apply relationship principles to real life care situations and creates a forum for discussion of the various perspectives.
