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  3. Investigating the barriers to the establishment of the open visit system in special care departments from the point of view of health service providers in hospitals affiliated to Urmia University of Medical Sciences in the year

Investigating the barriers to the establishment of the open visit system in special care departments from the point of view of health service providers in hospitals affiliated to Urmia University of Medical Sciences in the year

Number of pages: 106 File Format: word File Code: 31974
Year: 2010 University Degree: Master's degree Category: Health - Health
Tags/Keywords: attitude - free meeting - hospital - Limited meeting - Open meeting system - sick - Special care - Special care units - Theory of reason-based action
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  • Summary of Investigating the barriers to the establishment of the open visit system in special care departments from the point of view of health service providers in hospitals affiliated to Urmia University of Medical Sciences in the year

    dissertation to receive a master's degree in nursing

    special care orientation

    abstract

    Background and purpose: visits in special care units have been limited for a long time. The unknown, on the other hand, doubles the tension and is a crisis for the patient and the family and causes them great confusion and worry. But today, in addition to the fact that there is no reason to justify limited visits in special departments, its usefulness has also been proven, but despite this, most medical institutions have a limited visit system. The purpose of this research is to examine the barriers to the establishment of the open visit system from the perspective of health service providers in four dimensions: attitudinal, knowledge, physical barriers and cultural barriers. Materials and methods: This study is quantitative and descriptive with three groups of participants, including nurses, doctors and senior managers working in hospitals affiliated to Urmia University of Medical Sciences. Each group filled a questionnaire with 40 questions on a Likert scale, whose validity and reliability have been verified. Then the resulting information was analyzed using SPSS16.0/win statistical software. Findings: The total number of participants was 336, the average age of the participants was 35.38 years, and 66.7% of them were women. The average work in intensive care units was 60.47 months. The attitude score of the participants towards the implementation of the open meeting system was 57.58 out of 100 points and their knowledge score about the benefits of open meeting was 9.43 out of 20 points. The lack of space and the absence of separate beds are among the most important physical obstacles, and the lack of awareness of the process of illness and treatment and the lack of emotional control are among the most important cultural obstacles.

    Conclusion: In the framework of Ajzen and Fishbein's theory and Rogers' innovation diffusion model, attitude is the most important reason for creating behavior. Due to the negative attitude of medical personnel and little knowledge about the benefits of open visits, education and increasing knowledge about the advantages of open visits is the most important solution to change attitudes and accept innovation. In relation to the physical obstacles of lack of space, too many beds, followed by the problem of department management and the possibility of violating the patient's privacy. Also, in relation to cultural barriers, stress and confusion of the family can be solved to a great extent with the presence and guidance of an expert and psychologist.

    Key words: limited meeting, open meeting, attitude, reason-based theory of action

    The chapter includes statement of the problem, the research context, the importance of the study for nursing knowledge, and an overview of the conducted researches.

    1-1 :Introduction

    The intensive care unit [1] is a unit where the most critical patients are cared for and treated by the most qualified personnel under the best conditions and the most equipped equipment available. In other words, the special care department is the department where the highest continuous care of the patient and his treatment is possible. The use of new surgical and treatment methods is not complete without this department[1].

    The history of the establishment of the special care department goes back to the time of World War II in 1940. At that time, doctors came to the conclusion that in order to reduce the death rate, critically injured patients should be treated and cared for separately, continuously, and carefully, so they established special care units in frontline hospitals. Nurses with great skills and experience were selected for these departments. Gradually, special care departments were established in city hospitals. Since 1970, specialized intensive care units have been developed alongside general intensive care units [1].

    Patients who are very sick and in critical condition are unable to take care of themselves and their vital systems are disrupted. Such patients are admitted to the intensive care unit. The death rate in these areas is usually high. However, the intensive care unit should not be considered a place for patients to die.Also, considering that the cost of hospitalization in special care units is very high, patients should be selected for hospitalization in these units who really need special care and there is hope for their recovery[1]. The intensive care unit is usually established in large and well-equipped hospitals and may be general or specialized. According to the type of patients and surgeries, some hospitals may have specialized departments including surgery[2], internal medicine, neurosurgery, heart surgery, burns, kidney transplant, infants[3] and children[2]. In addition to nurses, a doctor (anaesthesiologist or lung specialist as the head of the department) must be present in the department. In the public special care department, one nurse is needed for each patient. Physiotherapist and nutritionist are available to take care of the nutritional status of this hospital. Also, there are enough trained personnel in the department.

    The characteristics that the personnel of this department should have is that each of them has completed a specialized course in their field, and in addition, they should be kind, compassionate, interested, patient, have good dealings with anxious companions, correct and respectful communication with colleagues [2].

    More than five million people in Intensive care units are admitted across the United States, and about 10 to 20 percent of these people die. Among these hospitalized people, only about 25% of them are able to communicate and participate in decisions to achieve treatment goals. In other cases, it is the family members who help the health care team in the most important treatment decisions. For this reason, they are referred to as a member of the treatment team [2]. But the family faces a serious crisis due to an incident, accident or a completely unfamiliar situation and an acute illness for one of its members, and this crisis threatens the individual, interpersonal and social integrity of the family members and puts it under tension. Fear of the future, fear of losing a family member, fear of the financial burden caused by illness, change in family roles, disappointment and loneliness, anxiety and depression, and the lack of enough time to adapt make this tension more intense and make family members suffer from post-traumatic stress disorders in more than a third of cases [4]. In such a case, the decision-making power of the family can be significantly affected and lead to making wrong decisions [3]. Many social science experts have described the family as an integrated social system that disease can disrupt the integrity of this system. Since the family and family life is an essential part of the health of every individual and has a great importance and role for the patient, it should be considered as important as the patient himself in the nursing and medical intervention program [4]. Today, the care environment includes patients and families, and in this regard, in order to achieve complete care and a favorable treatment environment, the active participation of the family must be continued, and by implementing care with a comprehensive view, the needs of the family are also considered as important as the needs of the patients and are considered separate from each other. 4.

    Abstract

    Introduction: Visiting in intensive care units has long been limited. Restricted visiting and separation of patient and family from one hand and Faced with an unfamiliar environment, fear of the unknown from another hand will double stress. But today, in addition to any other reason to justify the restricted visiting does not exist it also found to be useful. However, most medical institutions have a restricted visiting policy in intensive care units. The goal of this research to determine barriers of open visiting in intensive care units from the viewpoint of healthcare providers in four dimensions: Attitude, Knowledge, physical and cultural.

  • Contents & References of Investigating the barriers to the establishment of the open visit system in special care departments from the point of view of health service providers in hospitals affiliated to Urmia University of Medical Sciences in the year

    List:

    Introduction 2.

    Research context 6.

    Statement of the problem 9.

    The importance of the study for nursing knowledge .10

    Overview of the conducted research 12.

    Chapter Two: Theoretical Framework

    Introduction. 18

    Theoretical view 18.

    Chapter three: research method

    Introduction 29.

    General objective 30.

    Specific objectives. 30. Research questions. 31. Definitions of words. 32. Type of research. 35. Research community. 35. Specifications of research units. 36. Sampling method and number of samples. 38. Data collection tools. 38. Determining the validity of the tool. 39. Determining the reliability of the tool. 39. Data analysis method. 40. Ethical considerations. 41. Chapter four: Research findings. Introduction. 43. Descriptive statistics related to the demographic information of the participants in Design 45. Descriptive statistics related to the general view of the participants in the project towards the establishment of the free visit system in intensive care units. 48. Descriptive statistics related to determining the level of knowledge of nurses working in special care units regarding the benefits of open visits. Related to the determination of physical obstacles in the establishment of the open visit system in special care departments from the point of view of health service providers. 62

    Descriptive statistics related to the determination of cultural barriers in the establishment of the open visit system in intensive care units from the perspective of health service providers. 64

    Chapter five: Research results

    Introduction 66

    Discussion and conclusion 67

    Application of findings 75

    Research limitations 76

    Suggestions for further studies. 78

    Resources. 80

    Appendices .85

    English abstract .90

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