How much information about antibiotics do people recall after consulting in primary care?

Family Practice  cmw022 first published online April 12, 2016 doi:10.1093/fampra/cmw022

Background. Sharing information with patients within a consultation about their infection and value of antibiotics can help reduce antibiotic prescriptions for respiratory tract infections. However, we do not know how often information is given about antibiotics or infections, and if this is related to knowledge and attitudes.

Objectives. To determine the public’s reported use of antibiotics, receipt of information from health professionals about antibiotics and resistance, trust in health professionals and knowledge levels about antibiotics and resistance.

Methods. Face-to-face computer-assisted survey with 1625 adults over 15 years in randomly selected households using multistage sampling. Rim weighting was used to correct for any selection biases.

Results. About 88% trusted their GP to determine the need for antibiotics. Of those who took antibiotics in the past year, 62% were for a throat infection, 60% for sinus infection and 42% for a cough. Although 67% who had been prescribed an antibiotic recalled being given advice about their infection or antibiotics, only 8% recalled information about antibiotic resistance. Those in lower social grades were less likely to recall advice. About 44% correctly indicated that antibiotics effectively treat bacterial rather than viral infections. Only 45% agreed that ‘healthy people can carry antibiotic resistant bacteria’.

Conclusion. GPs and health carers are trusted decision-makers, but could share more information with patients about the need or not for antibiotics, self-care and antibiotic resistance, especially with younger patients and those of lower social grade. Better ways are needed for effective sharing of information about antibiotic resistance.

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Strengthening leadership as a catalyst for enhanced patient safety culture: a repeated cross-sectional experimental study

BMJ Open 2016;6:e010180

Objectives Current literature emphasises that clinical leaders are in a position to enable a culture of safety, and that the safety culture is a performance mediator with the potential to influence patient outcomes. This paper aims to investigate staff’s perceptions of patient safety culture in a Danish psychiatric department before and after a leadership intervention.

Methods A repeated cross-sectional experimental study by design was applied. In 2 surveys, healthcare staff were asked about their perceptions of the patient safety culture using the 7 patient safety culture dimensions in the Safety Attitudes Questionnaire. To broaden knowledge and strengthen leadership skills, a multicomponent programme consisting of academic input, exercises, reflections and discussions, networking, and action learning was implemented among the clinical area level leaders.

Results In total, 358 and 325 staff members participated before and after the intervention, respectively. 19 of the staff members were clinical area level leaders. In both surveys, the response rate was >75%. The proportion of frontline staff with positive attitudes improved by ≥5% for 5 of the 7 patient safety culture dimensions over time. 6 patient safety culture dimensions became more positive (increase in mean) (p<0.05). Frontline staff became more positive on all dimensions except stress recognition (p<0.05). For the leaders, the opposite was the case (p<0.05). Staff leaving the department after the first measurement had rated job satisfaction lower than the staff staying on (p<0.05).

Conclusions The improvements documented in the patient safety culture are remarkable, and imply that strengthening the leadership can act as a significant catalyst for patient safety culture improvement. Further studies using a longitudinal study design are recommended to investigate the mechanism behind leadership’s influence on patient safety culture, sustainability of improvements over time, and the association of change in the patient safety culture measures with change in psychiatric patient safety outcomes.

Exploring the views of GPs, people with dementia and their carers on assistive technology: a qualitative study

BMJ Open 2016;6:e011132

Objectives To explore the views and experiences of people with dementia, their family carers and general practitioners (GPs) on their knowledge and experience of accessing information about, and use of, assistive technology (AT) in dementia care.

Design Qualitative methods with semistructured interviews and thematic analysis.

Participants 56 participants comprising 17 GPs, 13 people with dementia and 26 family carers.

Setting Community care settings in the North East of England.

Results 4 main themes emerged: awareness and experience of AT; accessing information on AT; roles and responsibilities in the current care system and the future commissioning of AT services. All participants had practical experience of witnessing AT being used in practice. For people with dementia and their families, knowledge was usually gained from personal experience rather than from health and social care professionals. For GPs, knowledge was largely gained through experiential, patient-led learning. All groups acknowledged the important role of the voluntary sector but agreed a need for clear information pathways for AT; such pathways were perceived to be essential to both service providers and service commissioners.

Conclusions People with dementia and their family carers appear to be mainly responsible for driving a gradual increase in both awareness and the use of AT in dementia care. GPs should be equipped with the relevant knowledge to ensure families living with dementia receive appropriate information and support to enable them to live independently for as long as possible. There is an urgent need to simplify current complex community care pathways; as demonstrated in other chronic health conditions, a single point of access and a named lead professional may improve future care.

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image source: http://bmjopen.bmj.com/

Integrated care to address the physical health needs of people with severe mental illness: a rapid review

Health Services and Delivery Research, Volume 4 Issue 13 April 2016
People with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests that this discrepancy is driven by a combination of clinical risk factors, socioeconomic factors and health system factors. The objective of this research was to explore current service provision and map the recent evidence on models of integrated care addressing the physical health needs of people with severe mental illness primarily within the mental health service setting.

Better care in my hands: A review of how people are involved in their care

 Better Care In My Hands describes how well people are involved in their own care and what good involvement looks like. | Care Quality Commission

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image source: http://www.cqc.org

People’s right to being involved in their own care is enshrined in law in the fundamental standards of care. It is an essential part of person-centred care and leads to better and often more cost effective outcomes.

This report is based on newly analysed evidence from CQC national reports and inspection findings, as well as national patient surveys and a literature review. It identifies what enables people and their families to work in partnership with health and social care staff and illustrates this with good practice examples from our inspection findings.

Key findings

  • Just over half of people asked say they feel definitely involved in decisions about their health care and treatment.
  • Women who use maternity services are particularly positive about how well they are involved in decisions about their care.
  • We found examples of good practice of people’s involvement in their care in our inspections over the last year.
  • There has been little change in people’s perceptions of how well they are involved in their health or social care over the last five years.
  • Some groups of people are less involved in their care than others. They are:
    • Adults and young people with long term physical and mental health conditions.
    • People with a learning disability.
    • People over 75 years old.
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image source: http://www.cqc.org