uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
'It's a matter of patient safety': understanding challenges in everyday clinical practice for achieving good care on the surgical ward – a qualitative study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
Department of Surgery, Uppsala University Hospital, Uppsala, Sweden.
Linkoping Univ, Res & Dev Unit Local Hlth Care, Linkoping, Sweden.; Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden..
2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 2, 323-331 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Surgical care plays an important role in the acute hospital's delivery of safe, high-quality patient care. Although demands for effectiveness are high in surgical wards quality of care and patient safety must also be secured. It is therefore necessary to identify the challenges and barriers linked to quality of care and patient safety with a focus on this specific setting.

AIM: To explore situations and processes that support or hinder good safe patient care on the surgical ward.

METHOD: This qualitative study was based on a strategic sample of 10 department and ward leaders in three hospitals and six surgical wards in Sweden. Repeated reflective interviews were analysed using systematic text condensation.

FINDINGS: Four themes described the leaders' view of a complex healthcare setting that demands effectiveness and efficiency in moving patients quickly through the healthcare system. Quality of care and patient safety were often hampered factors such as a shift of care level, with critically ill patients cared for without reorganisation of nurses' competencies on the surgical ward.

CONCLUSIONS: There is a gap between what is described in written documents and what is or can be performed in clinical practice to achieve good care and safe care on the surgical ward. A shift in levels of care on the surgical ward without reallocation of the necessary competencies at the patient's bedside show consequences for quality of care and patient safety. This means that surgical wards should consider reviewing their organisation and implementing more advanced nursing roles in direct patient care on all shifts. The ethical issues and the moral stress on nurses who lack the resources and competence to deliver good care according to professional values need to be made more explicit as a part of the patient safety agenda in the surgical ward.

Place, publisher, year, edition, pages
2017. Vol. 31, no 2, 323-331 p.
Keyword [en]
patient safety, quality of care, ethics, surgical ward, surgical nursing, leadership, qualitative approaches
National Category
Nursing
Identifiers
URN: urn:nbn:se:uu:diva-303524DOI: 10.1111/scs.12350ISI: 000404644100013PubMedID: 27439568OAI: oai:DiVA.org:uu-303524DiVA: diva2:972177
Available from: 2016-09-20 Created: 2016-09-20 Last updated: 2017-10-30Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Jangland, Eva

Search in DiVA

By author/editor
Jangland, Eva
By organisation
Department of Surgical Sciences
In the same journal
Scandinavian Journal of Caring Sciences
Nursing

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 411 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf