Table 5 Priorities for research to improve fundamental care on hospital wards
From: Determining priorities for research to improve fundamental care on hospital wards
Research themes (rank position after voting) | Views from the consultation |
|---|---|
1. Nurse staffing | |
- Having time (eg. member of staff taking time to find carer, time to do complete care) - Lack of time (eg. to respond to call bells, care undone) - Nurse workloads - Sufficient time for staff to be able to take breaks - Improving staffing levels - Use of agency staff (to cover shortages) | • When asked about care that had not gone well−28 % of survey respondents referred to staffing levels • Most frequent response to the question ‘if we could focus on just one factor care which would it be?’ (30 % selected it-twice as many as for other topics. It ranked ranking it no.1 out of 14) • Staff were more likely (37 %) than patients/public (14 %) to refer to ‘Nurse staffing’ as a priority topic |
2 = Individualised patient care | |
- Assessing patient care needs (fully) - Individualised care plans to meet patient needs (less reliance on standardised protocols) - Appropriate clinical care - Holistic/patient centred care - ‘Putting the patient first’ - Clear care plans - Treating the person not the condition | • This wasn’t listed as one of the ‘pre-set’ topics, but came up frequently in people’s answers on good and bad care, and what differentiates the two • Staff & patients/public both see this as key issue in good care (referred to by 32 % in the survey) • It emerges as an ‘over-arching theme’ to which all of the other topics connect |
2 = Staff Communication (generally) | |
- Between health care professionals - Sharing information between staff - Patient education: what to expect & how to have a say in their care - Style of communication-patient, skilful - Staff listening to patients - Honesty in communication | • Came up as a key issue in both staff and patient discussion groups • It was the most frequently discussed issue in relation to both good (43 %) and poor care (49 %)-and is the single issue accounting for most responses. • High ranking topic in response to ‘if we could only focus one topic’ (13 %) and had highest average research priority score (4.4 out of 5 for patients/public, 4.5 for staff) • Large proportion of patients/public refer to staff communication as factor when care has not gone well (60 %, vs 45 % staff) |
4. Staff attitudes & relationships with patients | |
- Ethos and values - ‘Care’ about patients - See patients as people - Maintaining compassion in staff - Relational care - ‘defensive medicine’ (making decisions on basis of being able to ‘defend’ them, rather than judgement of what is best for patient) | • An issue that came up as a theme in the patient/public discussion groups (closely linked to the communication themes) • The second most frequently cited issue raised in relation to quality of care-33 % refer to it in when talking about care that’s gone well, 31 % in relation to poor care. |
5. Information about care/communication | |
- Between staff and patients/carers - From patients to staff - Provision of information to patients - Informed consent procedures - Information (eg. using prompt sheet) | • One of the 3 topics that got highest ‘priority’ score (for both patients and staff-scoring 4.3 out of 5) • Some overlap with staff communication ‘generally’ |