Aims: To gain a deeper understanding of the differences in patients and staff per‐spectives in response to aggression and to explore recommendations on prevention.Design: Qualitative, grounded theory study.Methods: We conducted semi‐structured interviews with patients and nurses in‐volved in an aggressive incident. Data collection was performed from May 2016 ‐March 2017.Results: Thirty‐one interviews were conducted concerning 15 aggressive incidents.Patients and nurses generally showed agreement on the factual course of events,there was variation in agreement on the perceived severity (PS). Patients' recom‐mendations on prevention were mostly personally focussed, while nurses suggested general improvements.Conclusion: Patients are often capable to evaluate aggression and give recom‐mendations on prevention shortly after the incident. Patients and nurses differ inthe PS of aggression. Recommendations on prevention of patients and nurses arecomplementary.Impact: What problem did the study address? Perspectives of patients and nursesdiffer with respect to aggression, but how is unclear. What were the main findings?Patients and nurses generally described a similar factual course of events concern‐ing the incident, patients often perceive the severity less than nurses. Patients arecapable to give recommendations on prevention of aggressive incidents, shortly after the incident. Where and on whom will the research have impact? Factual course of events can be a common ground to start evaluating aggressive incidents and post‐incident review should address the severity of incidents. Asking recommendations
Background: Advanced medical technologies (AMTs), such as respiratory support or suction devices, are increasingly used in home settings and incidents may well result in patient harm. Information about risks and incidents can contribute to improved patient safety, provided that those are reported and analysed systematically. Objectives: To identify the frequency of incidents when using AMTs in home settings, the effects on patient outcomes and the actions taken by nurses following identification of incidents. Methods: A cross-sectional study of 209 home care nurses in the Netherlands working with infusion therapy, parenteral nutrition or morphine pumps, combining data from a questionnaire and registration forms covering more than 13 000 patient contacts. Descriptive statistics were used. Results: We identified 140 incidents (57 adverse events; 83 near misses). The frequencies in relation to the number of patient contacts were 2.7% for infusion therapy, 1.3% for parenteral nutrition and 2.6% for morphine pumps. The main causes were identified as related to the product (43.6%), the organisation of care (27.9%), the nurse as a user (15.7%) and the environment (12.9%). 40% of all adverse events resulted in mild to severe harm to the patient. Incidents had been discussed in the team (70.7%), with the patient/informal caregiver(s) (50%), or other actions had been taken (40.5%). 15.5% of incidents had been formally reported according to the organisation's protocol. Conclusions: Most incidents are attributed to product failures. Although such events predominantly cause no harm, a significant proportion of patients do suffer some degree of harm. There is considerable underreporting of incidents with AMTs in home care. This study has identified a discrepancy in quality circles: learning takes place at the team level rather than at the organisational level.
This qualitative study explored emotional responses of two white Dutch student teachers during a Critical Race Theory (CRT) based course. Following Plutchik's (2001) classification of 32 emotions, the analysis of their weekly diaries resulted in the identification of 16 emotions. In both diaries similar emotional responses were identified. However, the analysis did not reveal a straightforward path these students emotionally went through. The number and types of emotional responses, both comfortable and uncomfortable, fluctuated weekly and occurred simultaneously in various combinations. Even when similar emotional responses were identified, students connected differently to the course content. This could be explained by different starting points both students had when entering the course. The findings add to past work by identifying a variety and complexity of emotional responses of white student teachers during a CRT based course and can be used to create course conditions to prepare teachers for contributing to anti-racist education.
