ETHICAL DECISION MAKING IN ACTION: EVALUATING HOSPITAL CARE ATTENDANCE APPROACHES

##plugins.themes.bootstrap3.article.main##

##plugins.themes.bootstrap3.article.sidebar##

Published Dec 6, 2018
Julie E. Forbes Abigail M. Hebb Enrique Mu

Abstract

Patient safety is a priority in the hospital.  Hospitals are always considering cost effective ways to keep patients safe and free from harm.  Every year an average of 340,000 hospitalized patients are injured due to falls. Providing the best possible care attendance to prevent these incidents is very important.  It is demonstrated here that, beyond medical and financial considerations, the proper selection of care attendance is an ethical decision. This decision requires considering the needs of, as well as getting input from, all the parties involved (hospitals, nurses, and patients). Unfortunately, until now, the care attendance discussion has mainly considered the hospital’s perspective and rarely that of the patient. Using a stakeholder theoretical approach taken from ethical decision making literature and the Analytic Hierarchy Process which allows the integration of multiple stakeholder perspectives and the inclusion of intangible variables (such as patient’s perceived value), we developed an evaluation framework to enable the prioritization and allocation of resources to the different care attendance approaches: care attendant (CA), continuous video monitoring (CVM), normal rounding (NR) and family visitor sitters (FVS). The decision criteria have been identified from the extant medical evidence-based literature, and expert opinions from three decision-makers (each representing a particular stakeholder’s perspective) were used to assess the criteria weights and rate the alternatives.

How to Cite

Forbes, J. E., Hebb, A. M., & Mu, E. (2018). ETHICAL DECISION MAKING IN ACTION: EVALUATING HOSPITAL CARE ATTENDANCE APPROACHES. International Journal of the Analytic Hierarchy Process, 10(3). https://doi.org/10.13033/ijahp.v10i3.592

Downloads

Download data is not yet available.
Abstract 2875 | PDF Downloads 369

##plugins.themes.bootstrap3.article.details##

Keywords

Ethical Care, Patient Care, Care Attendant, Continuous video monitoring, Care Attendance

References
Babine, R. L., Hyrkas, K. E., Hallen, S., Wierman, H., Bachand, D., Chapman, J., & Fuller, V. (2018). Falls and delirium in an acute care setting: A retrospective chart review before and after an organisation-wide interprofessional education. Journal of Clinical Nursing, 27, 1429-1441. Doi: https://doi.org/10.1111/jocn.14259

Boswell, D. J., Ramsey, J., Smith, M. A., & Wagers, B. (2001). The cost-effectiveness of a patient-sitter program in an acute care hospital: A test of the impact of sitters on the incidence of falls and patient satisfaction. Quality Management in Health Care, 10(1), 10-16.

Burtson, P. L., & Vento, L. (2015). Sitter reduction through mobile video monitoring a nurse-driven sitter protocol and administrative oversight. The Journal of Nursing Administration, 45(7/8), 363-368. Doi: 10.1097/NNA.0000000000000216

Centers for Disease Control. (2017). Important facts about falls. Retrieved from http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

Colella, J., Aroh, D., Douglas, C., VanBuitenen, N., Galesi, J., Castro, A., Menacker, M. (2017). Managing delirium behaviors with one-to-one sitters. Nursing Management, 47(8), 1-5. Doi: 10.1097/01.NUMA.0000522172.15640.6b

Centers for Medicaid and Medicare Services. (2017, December 21). Retrieved August 14, 2018, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS.html

Cournan, M., Fusco-Gessick, B., & Wright, L. (2018). Improving patient safety through video monitoring. Rehabilitation Nursing, 43(2), 111-115. Doi:10.1002/rnj.308

Curtin, L. (1978). A proposed critical model for ethical analysis. Nursing Forum, XVII(1). Doi:10.1111/j.1744-6198.1978.tb01254.x

Danaf, J., Chang, B., Shaear, M., Johnson, K., Miller, S., Nester, L., Aboumater, H. (2017). Surfacing and addressing hospitalized patient’s needs: Proactive nursing rounding as a tool. Journal of Nursing Management, 00, 1-8. Doi: https://doi.org/10.1111/jonm.12580

Davis, J., Kutash, M., & Whyte IV, J. (2017). A comparative study of patient sitters with video monitoring versus in-room sitters. Journal of Nursing Education and Practice, 7(3), 137-142. Doi: https://doi.org/10.5430/jnep.v7n3p137

Dearmon, V., Roussel, L., Buckner, E., M., Pomrenke, B., Salas, S., Brown, A. (2013). Transforming care at the bedside (tab): Enhancing direct care and value-added care. Journal of Nursing Management, 21, 668-678. Doi: https://doi.org/10.1111/j.1365-2834.2012.01412.x

Fabry, D. (2015). Hourly rounding: Perspectives and perceptions of the frontline nursing staff. Journal of Nursing Management, 23, 200-210. Doi: https://doi.org/10.1111/jonm.12114

Freeman, R. E. (1984). Strategic management: A stakeholder approach. Cambridge, UK: Cambridge University Press. Doi: https://doi.org/10.1017/CBO9781139192675.003

Flowers, K., Wright, K., Langdon, R., Mcllwrath, M., Wainwright, C., & Johnson, M. (2016). Intentional rounding: Facilitators, benefits, and barriers. Journal of Clinical Nursing, 25, 1346-1355. Doi: https://doi.org/10.1111/jocn.13217

Goldsack, J., Bergey, M., Mascioli, S., & Cunningham, J. (2015). Hourly rounding and patient falls: What factors boost success? Nursing2015- Research Corner, 25-30. Doi: 10.1097/01.NURSE.0000459798.79840.95

Jeffers, S., Searcey, P., Herring, K., Lester, K., Goetz-Smith, H., & Nelson, P. (2013). Centralized video monitoring for patient safety: A Denver health lean journal. Nursing Economics, 31(6), 298-306.

The Joint Commission. (2017). Retrieved April 12, 2018, from https://www.jointcommission.org/standards_information/npsgs.aspx

Jong, L., Kitchen, S., & Hill, A. (2017). Exploring falls prevention capabilities, barriers and training needs among patient sitters in a hospital setting: A pilot survey. Geriatric Nursing, 1-8. Doi: https://doi.org/10.1016/j.gerinurse.2017.09.006

Kessler, B., Claude-Gutekunst, M., Donchez, A. M., Dries, R. F., & Snyder, M. M. (2012). The merry-go-round of patient rounding: Assure your patients get the brass ring. Medsurg Nursing, 21(4), 240-245.

Laws, D., & Crawford, C. (2013). Alternative strategies to constant patient observation and sitters. The Journal of Nursing Administration, 43(10), 497-501. Doi: 10.1097/NNA.0b013e3182a3e83e

Morgan, L., Flynn, L., Robertson, E., New, S., Forde-Johnston, C., & McCulloch, P. (2016). Intentional rounding: A staff-led quality improvement intervention in the prevention of patient falls. Journal of Clinical Nursing, 26, 115-124. Doi: https://doi.org/10.1111/jocn.13401

Mu, E., Cooper, O. and Peasley, A. (2018). Improving Analytic Network Process reporting. International Symposium of the Analytic Hierarchy Process, Hong Kong.

Mu, E., & Pereyra-Rojas, M. (2017). Practical decision making: An introduction to the Analytical Hierarchy Process (AHP) using Superdecisons v2. Springer Briefs in Operations Research:Springer International Publishing.

National Database for Nursing Quality Indicators. (2018). Retrieved August 14, 2018, from http://www.pressganey.com/solutions/clinical-quality/nursing-quality

Neville, K., Lake, K., LeMunyon, D., Paul, D., & Whitmore, K. (2012). Nurses; perceptions of patient rounding. The Journal of Nursing Administration, 42(2), 83-88. Doi: 10.1097/NNA.0b013e318243365e

Neville, K., DiBona, C., & Mahler, M. (2016). Validation of the nurse’s perception of patient rounding scale: An exploratory study of the influence of shift work on nurses' perception of patient rounding. Orthopedic Nursing, 35(2), 84-912. Doi: 10.1097/NOR.0000000000000223

Rochefort, C., Buckeridge, D., & Abrahamowicz, M. (2015). Improving patient safety by optimizing the use of nursing human resources. Implementation Science, 10(89), 1-11.

Saaty, T. L. (2001). Decision Making for Leaders: The Analytic Hierarchy Process for decisions in a complex world. Pittsburgh, PA: RWS Publications.

Saaty, T. L. and Ozdemir, M. S. (2005). The Encyclicon: A dictionary of decisions with dependence and feedback based on the Analytic Network Process. Pittsburgh, PA: RWS Publications.

Sand-Jecklin, K., Johnson, J. R., & Tylka, S. (2016). Protecting patient safety: can video monitoring prevent falls in high-risk patient populations. Journal of Nursing Care Quality, 31, 131-138. Doi: 10.1097/NCQ.0000000000000163

Schoberer, D., Breimaier, H., Mandl, M., Halfens, R., & Lohrmann, C. (2016). Involving the consumers: A exploration of user’s' and caregiver’s needs and expectations on a fall prevention brochure: A qualitative study. Geriatric Nursing, 37, 207-214. Doi: https://doi.org/10.1016/j.gerinurse.2016.02.011

Solimine, S., Takeshita, J., Goebert, D., Lee, J., Schultz, B., Guerrero, M., Lawyer, L. (2018). Characteristics of patients with constant observers. Psychosomatics, 59(1), 67-74. Doi: https://doi.org/10.1016/j.psym.2017.08.003

Super Decisions (2018). Super Decisions. Retrieved from https://www.superdecisions.com/

Torkelson, D., & Dobal, M. (1999). Constant observation in medical-surgical settings: A multi hospital study. Nursing Economics, 17(3), 149-155.

Tzeng, H., & Yin, C. (2007). Using family visitors, sitters, or volunteers to prevent falls. Journal of Nursing Administration, 37(78), 329-334. Doi: 10.1097/01.NNA.0000285116.68313.c1

Tzeng, H., & Yin, C. (2009). Inpatient falls: The impact of family and personal caregivers. Applied Nursing Research, 22, 159-165. Doi: https://doi.org/10.1016/j.apnr.2007.09.002

Tzeng, H., Yin, C., & Grunawalt, J. (2008). Effective assessment of use of sitters by nurses in inpatient care setting. Journal of Advanced Nursing, 64(2), 176-184. Doi: https://doi.org/10.1111/j.1365-2648.2008.04779.x

Votruba, L., Graham, B., Wisinski, J., & Syed, A. (2016). Video monitoring to reduce falls and patient companion costs for adult inpatients. Nursing Economics, 34, 185-189.

Wood, J. (2001). Ethical decision making. Journal of PeriAnesthesia Nursing, 16(1), 6-10. Doi: https://doi.org/10.1053/jpan.2001.18202
Section
Articles

Most read articles by the same author(s)

1 2 3 4 5 6 7 > >>