Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/32659
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dc.contributor.authorWright, Breanna-
dc.contributor.authorPlant, Bernice-
dc.contributor.authorLennox, Alyse-
dc.contributor.authorFaulkner, Nicholas-
dc.contributor.authorBragge, Peter-
dc.contributor.authorDoric, Andrea-
dc.contributor.authorJones, Daryl A-
dc.contributor.authorLeung, Christopher-
dc.date2023-
dc.date.accessioned2023-04-14T02:47:37Z-
dc.date.available2023-04-14T02:47:37Z-
dc.date.issued2023-11-
dc.identifier.citationAustralian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses 2023-11; 36(6)en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/32659-
dc.description.abstractNurses and junior doctors are often the first clinicians to recognise signs of deterioration in patients. However, there can be barriers to having conversations about escalation of care. The aim of this study was to study the frequency and nature of barriers encountered during discussions related to escalation of care for deteriorating hospitalised patients. This was a prospective observational study with daily experience sampling surveys related to escalation of care discussions. The study setting involved two teaching hospitals in Victoria, Australia. Consented doctors, nurses, and allied health staff members involved in routine care of adult ward patients participated in the study. The main outcome measures included the frequency of escalation conversations and the frequency and nature of barriers encountered during such conversations. 31 clinicians participated in the study and completed an experience sampling survey 294 times, mean (standard deviation) = 9.48 (5.82). On 166 (56.6%) days, staff members were on clinical duties, and escalation of care discussions occurred on 67 of 166 (40.4%) of these days. Barriers to escalation of care occurred in 25 of 67 (37.3%) of discussions and most frequently involved lack of staff availability (14.9%), perceived stress in the contacted staff member (14.9%), perceptions of criticism (9.0%), being dismissed (7.5%), or indication of lack of clinical appropriateness in the response (6.0%). Discussions related to escalation of care by ward clinicians occur in almost half of clinical days and are associated with barriers in one-third of discussions. Interventions are needed to clarify roles and responsibilities and outline behavioural expectations on both sides of the conversation and enable respectful communication amongst individuals involved in discussions of escalation of patient care.en_US
dc.language.isoeng-
dc.subjectBarriersen_US
dc.subjectCommunicationen_US
dc.subjectEscalation of careen_US
dc.subjectPatient careen_US
dc.subjectPatient safetyen_US
dc.titleThe frequency and nature of barriers to escalation of care in two Australian teaching hospitals.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleAustralian Critical Care : official journal of the Confederation of Australian Critical Care Nursesen_US
dc.identifier.affiliationBehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Australia.en_US
dc.identifier.affiliationEastern Health, Victoria, Australia.en_US
dc.identifier.affiliationIntensive Careen_US
dc.identifier.affiliationUniversity of Melbourne Clinical Schoolen_US
dc.identifier.doi10.1016/j.aucc.2023.02.006en_US
dc.type.contentTexten_US
dc.identifier.pubmedid37005210-
local.name.researcherJones, Daryl A-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptIntensive Care-
crisitem.author.deptGastroenterology and Hepatology-
crisitem.author.deptUniversity of Melbourne Clinical School-
crisitem.author.deptClinical Education-
crisitem.author.deptMedicine (University of Melbourne)-
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