COGNITIVE ATTENTION TO REBUILD AUTOMATIC COGNITIVE BEHAVIORS FOR PATIENT SAFETY

2.50
Hdl Handle:
http://hdl.handle.net/10755/211657
Type:
Research Study
Title:
COGNITIVE ATTENTION TO REBUILD AUTOMATIC COGNITIVE BEHAVIORS FOR PATIENT SAFETY
Abstract:
Aims: The study was aimed at determining the effectiveness of the intervention-positive power dynamic action communication intervention strategy (PACIS) in producing the desired theoretical mediating variable of perceived faculty leadership support for patient safety and rebuilding memory bundles for the ultimate outcome of improved hand-hygiene (HH). The study completed an initial investigation of the utility of the theory-based PACIS in an undergraduate baccalaureate nursing clinical simulation setting by conducting a formative evaluation of the intervention. The ultimate goal was to achieve student participant habitual HH behavior in the simulation setting resulting in performance transfer to the actual clinical setting. Background: Our knowledge concerning best practices for making patient safety strategies “second nature” is limited. Further, researchers have designed few intervention studies to promote patient safety from a cognition perspective-building patient safety tasks that contain both the procedure rules and the skill within the same memory sequence. There is a scarcity of research on the methods faculty should use to ingrain patient safety strategies for student habitual execution. Methods: A quasi-experimental design with repeated measures was used. A total of 7 clinical faculty members and 57 senior II students in 14 clinical simulation groups were recruited and participated in the study. The intervention groups received a manualized intervention of one-on-one three-minute communication on hand hygiene and ten minutes direct performance observation. A communication fidelity checklist was used. Time in simulation was captured using a chronograph timer. The control groups received standard benefit. An intervention acceptability measurement tool evaluated acceptability and feasibility of the intervention for the faculty and the student participant. Hand-hygiene adherence data collection forms were completed real-time at each measurement opportunity. The Agency for HealthCare Research & Quality (AHRQ) Hospital Survey on Patient Safety Culture under “Supervisor/manager expectations and actions promoting patient safety” measured faculty leadership support for patient safety. Results: Overall, participants in the treatment group found the intervention acceptable. The odds of an individual in the intervention group adhering to HH performance guidelines are six times larger (95% CI: 3.0 to 12.1 times) than those in the control group. The odds of an individual in the intervention group adhering before when indicated are four times larger (95% CI: 2.0 to 9.4 times) than those in the control group. The odds of an individual in the intervention group adhering after when indicated are six times larger (95% CI: 3.5 to 12.8 times) than those in the control group. The odds of HH adherence doubles [(1.078 )10 @ 2.11] for every ten minutes increase in faculty time in simulation. There was no difference between groups of perceived faculty leadership for patient safety. Implications: The low complexity of the intervention and the personal belief in the intervention by the faculty coupled with the student assessment of the reasonableness of the intervention should enhance the application of the intervention as a strategy to enhance patient safety performance.  Further research, examining the performance of students in the simulation environment and in the natural environment, is critical to the development of effective patient safety interventions.
Keywords:
Patient safety; Intervention; Cognitive behaviors
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5667
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleCOGNITIVE ATTENTION TO REBUILD AUTOMATIC COGNITIVE BEHAVIORS FOR PATIENT SAFETYen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211657-
dc.description.abstractAims: The study was aimed at determining the effectiveness of the intervention-positive power dynamic action communication intervention strategy (PACIS) in producing the desired theoretical mediating variable of perceived faculty leadership support for patient safety and rebuilding memory bundles for the ultimate outcome of improved hand-hygiene (HH). The study completed an initial investigation of the utility of the theory-based PACIS in an undergraduate baccalaureate nursing clinical simulation setting by conducting a formative evaluation of the intervention. The ultimate goal was to achieve student participant habitual HH behavior in the simulation setting resulting in performance transfer to the actual clinical setting. Background: Our knowledge concerning best practices for making patient safety strategies “second nature” is limited. Further, researchers have designed few intervention studies to promote patient safety from a cognition perspective-building patient safety tasks that contain both the procedure rules and the skill within the same memory sequence. There is a scarcity of research on the methods faculty should use to ingrain patient safety strategies for student habitual execution. Methods: A quasi-experimental design with repeated measures was used. A total of 7 clinical faculty members and 57 senior II students in 14 clinical simulation groups were recruited and participated in the study. The intervention groups received a manualized intervention of one-on-one three-minute communication on hand hygiene and ten minutes direct performance observation. A communication fidelity checklist was used. Time in simulation was captured using a chronograph timer. The control groups received standard benefit. An intervention acceptability measurement tool evaluated acceptability and feasibility of the intervention for the faculty and the student participant. Hand-hygiene adherence data collection forms were completed real-time at each measurement opportunity. The Agency for HealthCare Research & Quality (AHRQ) Hospital Survey on Patient Safety Culture under “Supervisor/manager expectations and actions promoting patient safety” measured faculty leadership support for patient safety. Results: Overall, participants in the treatment group found the intervention acceptable. The odds of an individual in the intervention group adhering to HH performance guidelines are six times larger (95% CI: 3.0 to 12.1 times) than those in the control group. The odds of an individual in the intervention group adhering before when indicated are four times larger (95% CI: 2.0 to 9.4 times) than those in the control group. The odds of an individual in the intervention group adhering after when indicated are six times larger (95% CI: 3.5 to 12.8 times) than those in the control group. The odds of HH adherence doubles [(1.078 )10 @ 2.11] for every ten minutes increase in faculty time in simulation. There was no difference between groups of perceived faculty leadership for patient safety. Implications: The low complexity of the intervention and the personal belief in the intervention by the faculty coupled with the student assessment of the reasonableness of the intervention should enhance the application of the intervention as a strategy to enhance patient safety performance.  Further research, examining the performance of students in the simulation environment and in the natural environment, is critical to the development of effective patient safety interventions.en_GB
dc.subjectPatient safetyen_GB
dc.subjectInterventionen_GB
dc.subjectCognitive behaviorsen_GB
dc.date.available2012-02-20T12:06:44Z-
dc.date.issued2012-02-20T12:06:44Z-
dc.date.accessioned2012-02-20T12:06:44Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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