A longitudinal qualitative study of health care personnel’s perceptions of simultaneous implementation of three risk assessment scales on falls, malnutrition and pressure ulcers
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Original versionSkytt, B., Engström, M., Mårtensson, G. & Anna-Greta Mamhidir, A.-G. (2016). A longitudinal qualitative study of health care personnel’s perceptions of simultaneous implementation of three risk assessment scales on falls, malnutrition and pressure ulcers. Journal of Clinical Nursing, 25(13–14), 1912–22. https://doi.org/10.1111/jocn.13207
Aims and objectives In this study, the aim was to understand health care personnel's expectations and experiences of participating in an intervention aimed at the implementation of three assessment scales for fall injuries, malnutrition and pressure ulcers, and the performance of preventive measures in these areas over the period of 18 months. Background Fall injuries, malnutrition and pressure ulcers among older people are challenging issues for caregivers at different levels in the health care system. Design A descriptive design with a qualitative approach was used to follow health care personnel before, during and after implementation of a care prevention intervention. Methods Twelve health care personnel with different professions at the hospital, primary care and municipal care levels participated in a preventive care introduction. Seminars were held at four occasions, with assignments to be completed between seminars. Lectures and group discussions were performed, and three risk assessment scales were introduced. The participants were interviewed before, during and after the introduction. Manifest and latent content analysis were used. Results The main results are presented in the theme ‘Patient needs are visualised through a gradually developed shared understanding’ and in five categories. The work approach of performing three risk assessments simultaneously was perceived as positive and central to ensuring quality of care; it was not, however, perceived as unproblematic. Conclusion The participants as well as health care team members showed a positive attitude towards and described the advantages of being given opportunities for shared understanding to improve patient safety and to provide structure for the provision of good care. Relevance to clinical practice The managerial approach of listening to and acting on issues stressed by health care personnel is important to ensure ongoing and future improvement initiatives. What does this paper contribute to the wider global clinical community? This study shows that health care personnel working at three health care levels; hospital, primary care and municipal care, experienced simultaneous implementation of three risk assessment scales to improve patient safety and structuring of work. Although personnel had a positive attitude towards performing risk assessments, problems with insufficient documentation routines and ICT systems were experienced. Reflections on and shared understanding of patients’ care needs, brought about when working with the three scales simultaneously, probably contributed to health care team's positive attitudes.