International Journal of Older People Nursing, Jul 7, 2021
BackgroundDespite the common perception of the call light system as crucial for patient safety, t... more BackgroundDespite the common perception of the call light system as crucial for patient safety, there are usability gaps between what features staff in nursing facilities need to address an alarm quickly and how the call system is designed. A survey instrument was developed to investigate nursing home staff experiences in using call light technology.MethodsA survey instrument was developed and distributed to staff in two nursing facilities in Up‐State, New York (N = 278). The strength and direction of relationships between pairs of variables were measured using Pearson correlation and analysis of variance to investigate the perceived effect of staff's perception of the call light system on the work system's elements, process and staff outcomes.ResultsThe study found correlations between the job‐level workload and the noise in the unit (r = 0.272, p = .000), between job‐level workload and the ease of locating call lights (r = 0.154, p = .023), and between job stress and burnout (r = 0.176, p = .009). Only 64% of nursing home staff believed that the call light system reflected urgent needs, with younger staff relating to this group. The staff gave the work environment a high score, which corresponds to excessive noises caused by the call light alarm, according to 74% of the staff. These associations stem from gaps caused by a lack of user feedback in the design and acquisition process, leading to usability issues that reduce performance and satisfaction over time.ConclusionThe study found that the type of call light system used is associated with usability challenges that often impeded the performance of the nursing home staff's response to residents. These insights can improve the selection of a new call light system that avoids usability issues and challenges identified by end‐users.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting, Nov 1, 2019
Most child-patients do not provide their own account of their healthcare experiences and are inst... more Most child-patients do not provide their own account of their healthcare experiences and are instead represented by their parents/legal guardians. A common belief is that children lack the perceptiveness, knowledge, experience, or maturity needed to answer questions on a complex subject such as their health and the care received while hospitalized. However, the literature suggests that children can provide valuable feedback about their experiences, which can differ from the perspective of their parent/guardian. The overall goal of this project is to 1. Determine whether child-patients perceive their healthcare experiences differently than their parents. 2. Identify the key domains whereby they differ. 3. Evaluate and explain the differences in perceived healthcare quality between child-patient and parent. 4. Develop innovative and engaging tools/instruments to obtain hospitalized children's experience and meaningful feedback. This paper will describe the methodology, insights, and challenges of developing the tools and instruments aimed at understanding how children define their quality of care. A semi-structured, 10 question interview and multiple versions of a 45-question survey instrument was prepared to test recently hospitalized children (ages 4-17) and their parent/guardian along eight key domains. While the goal of the interview is to identify the key domains that reflect a child's measures of quality, the survey seeks to provide a comprehensive outlook at a pediatric patient's experience from start to finish. Pilot testing showed that Cronbach alpha values were within the acceptable range (> 0.7), and younger children were consistently able to complete the interview and survey within 45-minute time. It was observed through the study that children have a unique awareness of their own experiences and can convey their thoughts if given the opportunity and were able to provide specific ideas for improvement.
Background: Pediatric patients can provide feedback about their healthcare experiences. However, ... more Background: Pediatric patients can provide feedback about their healthcare experiences. However, most do not and are instead represented by their parents. A widely accepted notion is that pediatric patients lack the capacity, vocabulary, and preferences needed to answer meaningful questions related to their healthcare. However, because the pediatric patients’ experience can differ from the perspective of their parents, the use of proxy reporting ultimately reduces the hospital’s ability to address the concerns of pediatric patients directly. Objectives: The overall goals of this survey study were (1) to identify the key domains whereby pediatric patient and parent preferences differ and (2) to investigate the extent to which pediatric patients perceive their healthcare experiences differently from their parents. Methods: This study employed an adult version, an older child version, and a younger child version of a 47-question survey instrument divided into seven key domains: experie...
Due to advances made in telehealth, and the growing usage of information and communication techno... more Due to advances made in telehealth, and the growing usage of information and communication technology in all growing sectors, patients have more control over their healthcare experience through greater access to information and their care providers. While the literature provides evidence supporting integrating more modern approaches, we find that patient rooms in hospital settings have largely ignored advances made in information and communication technology (ICT). This paper proposes a “smart” patient room layout designed not only to help improve communication, safety, and satisfaction of both patients and nurses but also to engage and empower patients by giving them access to technology and educational resources, in-room entertainment. Three smart devices were proposed in this paper as a way of transforming the quality, speed, accuracy, and experience of care services. First, a tablet was proposed to replace the original call light device in patients’ rooms. The second device disc...
Little research has been conducted to capture the perceptions of nursing home staff when using th... more Little research has been conducted to capture the perceptions of nursing home staff when using the call light system. There is also a lack of information regarding the effects that these perceptions of the call light system have on their workload, safety, quality of care, or overall satisfaction. In response to the high volume of complaints from residents and their families regarding long response times to call light alarms, we developed this exploratory cross-sectional survey study. This study aims to capture nursing home staff experiences while using a call light system; to investigate the challenges the staff face when using the system; and to determine how these challenges contribute to their workload, performance, and satisfaction. A survey instrument was developed and distributed to all 153 of the nursing staff, certified nursing assistants, and licensed practical nurses in a nursing home in upstate New York. A total of 105 completed surveys were retrieved for an overall respo...
Most child-patients do not provide their own account of their healthcare experiences and are inst... more Most child-patients do not provide their own account of their healthcare experiences and are instead represented by their parents/legal guardians. A common belief is that children lack the perceptiveness, knowledge, experience, or maturity needed to answer questions on a complex subject such as their health and the care received while hospitalized. However, the literature suggests that children can provide valuable feedback about their experiences, which can differ from the perspective of their parent/guardian. The overall goal of this project is to 1. Determine whether child-patients perceive their healthcare experiences differently than their parents. 2. Identify the key domains whereby they differ. 3. Evaluate and explain the differences in perceived healthcare quality between child-patient and parent. 4. Develop innovative and engaging tools/instruments to obtain hospitalized children’s experience and meaningful feedback. This paper will describe the methodology, insights, and c...
BACKGROUND Despite the common perception of the call light system as crucial for patient safety, ... more BACKGROUND Despite the common perception of the call light system as crucial for patient safety, there are usability gaps between what features staff in nursing facilities need to address an alarm quickly and how the call system is designed. A survey instrument was developed to investigate nursing home staff experiences in using call light technology. METHODS A survey instrument was developed and distributed to staff in two nursing facilities in Up-State, New York (N = 278). The strength and direction of relationships between pairs of variables were measured using Pearson correlation and analysis of variance to investigate the perceived effect of staff's perception of the call light system on the work system's elements, process and staff outcomes. RESULTS The study found correlations between the job-level workload and the noise in the unit (r = 0.272, p = .000), between job-level workload and the ease of locating call lights (r = 0.154, p = .023), and between job stress and burnout (r = 0.176, p = .009). Only 64% of nursing home staff believed that the call light system reflected urgent needs, with younger staff relating to this group. The staff gave the work environment a high score, which corresponds to excessive noises caused by the call light alarm, according to 74% of the staff. These associations stem from gaps caused by a lack of user feedback in the design and acquisition process, leading to usability issues that reduce performance and satisfaction over time. CONCLUSION The study found that the type of call light system used is associated with usability challenges that often impeded the performance of the nursing home staff's response to residents. These insights can improve the selection of a new call light system that avoids usability issues and challenges identified by end-users.
Introduction: Current research about frontline nurse stress and turnover intention lacks context ... more Introduction: Current research about frontline nurse stress and turnover intention lacks context related to rural communities' plight in providing organizational resources during the current COVID-19 pandemic. These implications have been particularly underexamined in the United States, whose regional differences may influence how frontline nurses perceive the access and utility of organizational resources. This study investigates if anxiety and stress while working during the current COVID-19 pandemic contribute to frontline nurses' desire to leave their current position in Alabama hospital settings. Material and Methods: A cross-sectional survey was developed and distributed as a Qualtrics survey to frontline nurses using social media and professional contacts. A total of 111 frontline nurse respondents within May 19-June 12, 2020 were included in this study. Results: A significant correlation was found between gender (p= 0.002), marital status (p= 0.000) and seniority (p= 0.049) on turnover intention. A nurse's perceived anxiety and stress related to their patients' acuity (r= 0.257, p= 0.004), their personal health as a risk factor (r= 0.507, p= 0.000), their patient assignments (r= 0.239, p= 0.01), their personal protective equipment (r= 0.412, p= 0.000), and their psychological support (r= 0.316, p= 0.001) correspond to higher turnover intention among nurses working with patients infected with COVID-19. Conclusion: Perceived resource loss in task autonomy, PPE, and psychosocial support increased turnover intention among frontline nurses in Alabama. Research is needed to understand how intrinsic motivations and social support influence individual nurse staff's perceptions of resource loss and job demands. Further, more research is necessary to examine the implications of rurality and place in discussing turnover intention and organizational resources across multiple health systems.
Background: Studies suggest that nursing staff during pandemics such as H1N1 Influenza and COVID-... more Background: Studies suggest that nursing staff during pandemics such as H1N1 Influenza and COVID-19 exhibit higher than usual stress levels due to an increasingly overburdened healthcare system and increasing infection rates. This study aims to investigate the major stressors and coping strategies reported by nurses working directly with potentially infectious patients in Alabama, United States, during the COVID-19 pandemic. Materials and Methods: A cross-sectional questionnaire study was conducted with nursing staff working in hospital settings in the state. The questionnaire was completed by 109 nurses working in hospitals that treated COVID-19 patients. Results: Around 71% of the nursing staff were concerned about receiving more COVID-19 patients and exhibited heightened workload-related stress resulting from taking care of infected patients. The study found that most nurses (82%) are stressed about getting their friends and family infected. Overall, younger, less experienced nurses reported more stress levels compared to older, senior-level nurses. Findings suggest that many nurses fail to perceive protective measures as an effective coping strategy, with only 75% reporting problem-solving strategies such as hand washing and wearing a face mask, and only 60% avoiding public transportation and crowded spaces. Findings also suggest a lack of organizational support including psychiatric assistance, with no nurses reportedly seeking psychological therapy. Conclusion: The COVID-19 pandemic increased the stress level of the nursing staff in Alabama. The study finds that the cases in the state of AL are still increasing dramatically, which can overwhelme the healthcare system and escalate nurse stress levels.
; and Thames, Robert (2020) "Collecting child-patient feedback: A systematic review on the patien... more ; and Thames, Robert (2020) "Collecting child-patient feedback: A systematic review on the patient-reported outcome measures for hospitalized children,"
Background: As the U.S. population continues to diversify, the recruitment and retention of a div... more Background: As the U.S. population continues to diversify, the recruitment and retention of a diverse and culturally competent nursing workforce is paramount to delivering high quality care. To meet this challenge, organizations may use diversity value signaling (DVS) in recruitment materials. DVS, defined as the use of inclusive language and terms in organizational communication, is an extension of Signaling Theory which suggests that the content in a job description provides both instrumental and symbolic signaling of the organization's values, goals, and expectations. The purpose of this study is to examine the prevalence of DVS in leading U.S. hospitals and to explore whether there is a relationship between DVS and performance. Methods: A purposive sample of hospitals from the 2021-2022 U.S. News Best Hospitals rankings was examined for the use of DVS content in nursing job advertisements from leading U.S. hospitals (n=100) to investigate the prevalence of DVS in leading hospitals and to explore the relationship between DVS and hospital performance. Results: Hospitals with DVS are ranked higher than hospitals that rely on compliance-based statements or no signaling at all. In addition, hospitals with no DVS have the lowest average patient experience. Among the hospitals without DVS, hospitals with compliance-based statements have a lower rank than those with nothing at all. Conclusions: This paper serves as a call for further research to examine diversity as a value in job recruitment and how DVS is related to nurse staffing and patient outcomes.
International Journal of Older People Nursing, Jul 7, 2021
BackgroundDespite the common perception of the call light system as crucial for patient safety, t... more BackgroundDespite the common perception of the call light system as crucial for patient safety, there are usability gaps between what features staff in nursing facilities need to address an alarm quickly and how the call system is designed. A survey instrument was developed to investigate nursing home staff experiences in using call light technology.MethodsA survey instrument was developed and distributed to staff in two nursing facilities in Up‐State, New York (N = 278). The strength and direction of relationships between pairs of variables were measured using Pearson correlation and analysis of variance to investigate the perceived effect of staff's perception of the call light system on the work system's elements, process and staff outcomes.ResultsThe study found correlations between the job‐level workload and the noise in the unit (r = 0.272, p = .000), between job‐level workload and the ease of locating call lights (r = 0.154, p = .023), and between job stress and burnout (r = 0.176, p = .009). Only 64% of nursing home staff believed that the call light system reflected urgent needs, with younger staff relating to this group. The staff gave the work environment a high score, which corresponds to excessive noises caused by the call light alarm, according to 74% of the staff. These associations stem from gaps caused by a lack of user feedback in the design and acquisition process, leading to usability issues that reduce performance and satisfaction over time.ConclusionThe study found that the type of call light system used is associated with usability challenges that often impeded the performance of the nursing home staff's response to residents. These insights can improve the selection of a new call light system that avoids usability issues and challenges identified by end‐users.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting, Nov 1, 2019
Most child-patients do not provide their own account of their healthcare experiences and are inst... more Most child-patients do not provide their own account of their healthcare experiences and are instead represented by their parents/legal guardians. A common belief is that children lack the perceptiveness, knowledge, experience, or maturity needed to answer questions on a complex subject such as their health and the care received while hospitalized. However, the literature suggests that children can provide valuable feedback about their experiences, which can differ from the perspective of their parent/guardian. The overall goal of this project is to 1. Determine whether child-patients perceive their healthcare experiences differently than their parents. 2. Identify the key domains whereby they differ. 3. Evaluate and explain the differences in perceived healthcare quality between child-patient and parent. 4. Develop innovative and engaging tools/instruments to obtain hospitalized children's experience and meaningful feedback. This paper will describe the methodology, insights, and challenges of developing the tools and instruments aimed at understanding how children define their quality of care. A semi-structured, 10 question interview and multiple versions of a 45-question survey instrument was prepared to test recently hospitalized children (ages 4-17) and their parent/guardian along eight key domains. While the goal of the interview is to identify the key domains that reflect a child's measures of quality, the survey seeks to provide a comprehensive outlook at a pediatric patient's experience from start to finish. Pilot testing showed that Cronbach alpha values were within the acceptable range (> 0.7), and younger children were consistently able to complete the interview and survey within 45-minute time. It was observed through the study that children have a unique awareness of their own experiences and can convey their thoughts if given the opportunity and were able to provide specific ideas for improvement.
Background: Pediatric patients can provide feedback about their healthcare experiences. However, ... more Background: Pediatric patients can provide feedback about their healthcare experiences. However, most do not and are instead represented by their parents. A widely accepted notion is that pediatric patients lack the capacity, vocabulary, and preferences needed to answer meaningful questions related to their healthcare. However, because the pediatric patients’ experience can differ from the perspective of their parents, the use of proxy reporting ultimately reduces the hospital’s ability to address the concerns of pediatric patients directly. Objectives: The overall goals of this survey study were (1) to identify the key domains whereby pediatric patient and parent preferences differ and (2) to investigate the extent to which pediatric patients perceive their healthcare experiences differently from their parents. Methods: This study employed an adult version, an older child version, and a younger child version of a 47-question survey instrument divided into seven key domains: experie...
Due to advances made in telehealth, and the growing usage of information and communication techno... more Due to advances made in telehealth, and the growing usage of information and communication technology in all growing sectors, patients have more control over their healthcare experience through greater access to information and their care providers. While the literature provides evidence supporting integrating more modern approaches, we find that patient rooms in hospital settings have largely ignored advances made in information and communication technology (ICT). This paper proposes a “smart” patient room layout designed not only to help improve communication, safety, and satisfaction of both patients and nurses but also to engage and empower patients by giving them access to technology and educational resources, in-room entertainment. Three smart devices were proposed in this paper as a way of transforming the quality, speed, accuracy, and experience of care services. First, a tablet was proposed to replace the original call light device in patients’ rooms. The second device disc...
Little research has been conducted to capture the perceptions of nursing home staff when using th... more Little research has been conducted to capture the perceptions of nursing home staff when using the call light system. There is also a lack of information regarding the effects that these perceptions of the call light system have on their workload, safety, quality of care, or overall satisfaction. In response to the high volume of complaints from residents and their families regarding long response times to call light alarms, we developed this exploratory cross-sectional survey study. This study aims to capture nursing home staff experiences while using a call light system; to investigate the challenges the staff face when using the system; and to determine how these challenges contribute to their workload, performance, and satisfaction. A survey instrument was developed and distributed to all 153 of the nursing staff, certified nursing assistants, and licensed practical nurses in a nursing home in upstate New York. A total of 105 completed surveys were retrieved for an overall respo...
Most child-patients do not provide their own account of their healthcare experiences and are inst... more Most child-patients do not provide their own account of their healthcare experiences and are instead represented by their parents/legal guardians. A common belief is that children lack the perceptiveness, knowledge, experience, or maturity needed to answer questions on a complex subject such as their health and the care received while hospitalized. However, the literature suggests that children can provide valuable feedback about their experiences, which can differ from the perspective of their parent/guardian. The overall goal of this project is to 1. Determine whether child-patients perceive their healthcare experiences differently than their parents. 2. Identify the key domains whereby they differ. 3. Evaluate and explain the differences in perceived healthcare quality between child-patient and parent. 4. Develop innovative and engaging tools/instruments to obtain hospitalized children’s experience and meaningful feedback. This paper will describe the methodology, insights, and c...
BACKGROUND Despite the common perception of the call light system as crucial for patient safety, ... more BACKGROUND Despite the common perception of the call light system as crucial for patient safety, there are usability gaps between what features staff in nursing facilities need to address an alarm quickly and how the call system is designed. A survey instrument was developed to investigate nursing home staff experiences in using call light technology. METHODS A survey instrument was developed and distributed to staff in two nursing facilities in Up-State, New York (N = 278). The strength and direction of relationships between pairs of variables were measured using Pearson correlation and analysis of variance to investigate the perceived effect of staff's perception of the call light system on the work system's elements, process and staff outcomes. RESULTS The study found correlations between the job-level workload and the noise in the unit (r = 0.272, p = .000), between job-level workload and the ease of locating call lights (r = 0.154, p = .023), and between job stress and burnout (r = 0.176, p = .009). Only 64% of nursing home staff believed that the call light system reflected urgent needs, with younger staff relating to this group. The staff gave the work environment a high score, which corresponds to excessive noises caused by the call light alarm, according to 74% of the staff. These associations stem from gaps caused by a lack of user feedback in the design and acquisition process, leading to usability issues that reduce performance and satisfaction over time. CONCLUSION The study found that the type of call light system used is associated with usability challenges that often impeded the performance of the nursing home staff's response to residents. These insights can improve the selection of a new call light system that avoids usability issues and challenges identified by end-users.
Introduction: Current research about frontline nurse stress and turnover intention lacks context ... more Introduction: Current research about frontline nurse stress and turnover intention lacks context related to rural communities' plight in providing organizational resources during the current COVID-19 pandemic. These implications have been particularly underexamined in the United States, whose regional differences may influence how frontline nurses perceive the access and utility of organizational resources. This study investigates if anxiety and stress while working during the current COVID-19 pandemic contribute to frontline nurses' desire to leave their current position in Alabama hospital settings. Material and Methods: A cross-sectional survey was developed and distributed as a Qualtrics survey to frontline nurses using social media and professional contacts. A total of 111 frontline nurse respondents within May 19-June 12, 2020 were included in this study. Results: A significant correlation was found between gender (p= 0.002), marital status (p= 0.000) and seniority (p= 0.049) on turnover intention. A nurse's perceived anxiety and stress related to their patients' acuity (r= 0.257, p= 0.004), their personal health as a risk factor (r= 0.507, p= 0.000), their patient assignments (r= 0.239, p= 0.01), their personal protective equipment (r= 0.412, p= 0.000), and their psychological support (r= 0.316, p= 0.001) correspond to higher turnover intention among nurses working with patients infected with COVID-19. Conclusion: Perceived resource loss in task autonomy, PPE, and psychosocial support increased turnover intention among frontline nurses in Alabama. Research is needed to understand how intrinsic motivations and social support influence individual nurse staff's perceptions of resource loss and job demands. Further, more research is necessary to examine the implications of rurality and place in discussing turnover intention and organizational resources across multiple health systems.
Background: Studies suggest that nursing staff during pandemics such as H1N1 Influenza and COVID-... more Background: Studies suggest that nursing staff during pandemics such as H1N1 Influenza and COVID-19 exhibit higher than usual stress levels due to an increasingly overburdened healthcare system and increasing infection rates. This study aims to investigate the major stressors and coping strategies reported by nurses working directly with potentially infectious patients in Alabama, United States, during the COVID-19 pandemic. Materials and Methods: A cross-sectional questionnaire study was conducted with nursing staff working in hospital settings in the state. The questionnaire was completed by 109 nurses working in hospitals that treated COVID-19 patients. Results: Around 71% of the nursing staff were concerned about receiving more COVID-19 patients and exhibited heightened workload-related stress resulting from taking care of infected patients. The study found that most nurses (82%) are stressed about getting their friends and family infected. Overall, younger, less experienced nurses reported more stress levels compared to older, senior-level nurses. Findings suggest that many nurses fail to perceive protective measures as an effective coping strategy, with only 75% reporting problem-solving strategies such as hand washing and wearing a face mask, and only 60% avoiding public transportation and crowded spaces. Findings also suggest a lack of organizational support including psychiatric assistance, with no nurses reportedly seeking psychological therapy. Conclusion: The COVID-19 pandemic increased the stress level of the nursing staff in Alabama. The study finds that the cases in the state of AL are still increasing dramatically, which can overwhelme the healthcare system and escalate nurse stress levels.
; and Thames, Robert (2020) "Collecting child-patient feedback: A systematic review on the patien... more ; and Thames, Robert (2020) "Collecting child-patient feedback: A systematic review on the patient-reported outcome measures for hospitalized children,"
Background: As the U.S. population continues to diversify, the recruitment and retention of a div... more Background: As the U.S. population continues to diversify, the recruitment and retention of a diverse and culturally competent nursing workforce is paramount to delivering high quality care. To meet this challenge, organizations may use diversity value signaling (DVS) in recruitment materials. DVS, defined as the use of inclusive language and terms in organizational communication, is an extension of Signaling Theory which suggests that the content in a job description provides both instrumental and symbolic signaling of the organization's values, goals, and expectations. The purpose of this study is to examine the prevalence of DVS in leading U.S. hospitals and to explore whether there is a relationship between DVS and performance. Methods: A purposive sample of hospitals from the 2021-2022 U.S. News Best Hospitals rankings was examined for the use of DVS content in nursing job advertisements from leading U.S. hospitals (n=100) to investigate the prevalence of DVS in leading hospitals and to explore the relationship between DVS and hospital performance. Results: Hospitals with DVS are ranked higher than hospitals that rely on compliance-based statements or no signaling at all. In addition, hospitals with no DVS have the lowest average patient experience. Among the hospitals without DVS, hospitals with compliance-based statements have a lower rank than those with nothing at all. Conclusions: This paper serves as a call for further research to examine diversity as a value in job recruitment and how DVS is related to nurse staffing and patient outcomes.
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