Family, nurse, and physician beliefs on family-centered rounds: A 21-site study.
Journal
Journal of hospital medicine
ISSN: 1553-5606
Titre abrégé: J Hosp Med
Pays: United States
ID NLM: 101271025
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
revised:
11
08
2022
received:
01
06
2022
accepted:
30
08
2022
pubmed:
23
9
2022
medline:
6
12
2022
entrez:
22
9
2022
Statut:
ppublish
Résumé
Variation exists in family-centered rounds (FCR). We sought to understand patient/family and clinician FCR beliefs/attitudes and practices to support implementation efforts. Patients/families and clinicians at 21 geographically diverse US community/academic pediatric teaching hospitals participated in a prospective cohort dissemination and implementation study. We inquired about rounding beliefs/attitudes, practices, and demographics using a 26-question survey coproduced with family/nurse/attending-physician collaborators, informed by prior research and the Consolidated Framework for Implementation Research. Out of 2578 individuals, 1647 (64%) responded to the survey; of these, 1313 respondents participated in FCR and were included in analyses (616 patients/families, 243 nurses, 285 resident physicians, and 169 attending physicians). Beliefs/attitudes regarding the importance of FCR elements varied by role, with resident physicians rating the importance of several FCR elements lower than others. For example, on adjusted multivariable analysis, attending physicians (odds ratio [OR] 3.0, 95% confidence interval [95% CI] 1.2-7.8) and nurses (OR 3.1, 95% CI 1.3-7.4) were much more likely than resident physicians to report family participation on rounds as very/extremely important. Clinician support for key FCR elements was higher than self-reported practice (e.g., 88% believed family participation was important on rounds; 68% reported it often/always occurred). In practice, key elements of FCR were reported to often/always occur only 23%-70% of the time. Support for nurse and family participation in FCR is high among clinicians but varies by role. Physicians, particularly resident physicians, endorse several FCR elements as less important than nurses and patients/families. The gap between attitudes and practice and between clinician types suggests that attitudinal, structural, and cultural barriers impede FCR.
Sections du résumé
BACKGROUND
Variation exists in family-centered rounds (FCR).
OBJECTIVE
We sought to understand patient/family and clinician FCR beliefs/attitudes and practices to support implementation efforts.
DESIGNS, SETTINGS AND PARTICIPANTS
Patients/families and clinicians at 21 geographically diverse US community/academic pediatric teaching hospitals participated in a prospective cohort dissemination and implementation study.
INTERVENTION
We inquired about rounding beliefs/attitudes, practices, and demographics using a 26-question survey coproduced with family/nurse/attending-physician collaborators, informed by prior research and the Consolidated Framework for Implementation Research.
MAIN OUTCOME AND MEASURES
Out of 2578 individuals, 1647 (64%) responded to the survey; of these, 1313 respondents participated in FCR and were included in analyses (616 patients/families, 243 nurses, 285 resident physicians, and 169 attending physicians). Beliefs/attitudes regarding the importance of FCR elements varied by role, with resident physicians rating the importance of several FCR elements lower than others. For example, on adjusted multivariable analysis, attending physicians (odds ratio [OR] 3.0, 95% confidence interval [95% CI] 1.2-7.8) and nurses (OR 3.1, 95% CI 1.3-7.4) were much more likely than resident physicians to report family participation on rounds as very/extremely important. Clinician support for key FCR elements was higher than self-reported practice (e.g., 88% believed family participation was important on rounds; 68% reported it often/always occurred). In practice, key elements of FCR were reported to often/always occur only 23%-70% of the time.
RESULT
Support for nurse and family participation in FCR is high among clinicians but varies by role. Physicians, particularly resident physicians, endorse several FCR elements as less important than nurses and patients/families. The gap between attitudes and practice and between clinician types suggests that attitudinal, structural, and cultural barriers impede FCR.
Identifiants
pubmed: 36131598
doi: 10.1002/jhm.12962
pmc: PMC10087029
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
945-955Subventions
Organisme : Patient-Centered Outcomes Research Institute
ID : DI-2017C3-9232 Principal Investigator: Dr. Christopher Landrigan
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022 The Authors. Journal of Hospital Medicine published by Wiley Periodicals LLC on behalf of Society of Hospital Medicine.
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