OAR@UM Collection:

Validation of the Collaborative Practice Assessment Tool (CPAT) and Assessment of Interprofessional Team Collaboration Scale (AITCS-II) to assess interprofessional collaboration in the ICU setting in a small EU island state

Sun, 01 Jan 2023 00:00:00 GMT

Title: Validation of the Collaborative Practice Assessment Tool (CPAT) and Assessment of Interprofessional Team Collaboration Scale (AITCS-II) to assess interprofessional collaboration in the ICU setting in a small EU island state Abstract: Interprofessional collaboration (IPC) occurs when multiple healthcare professionals from diverse disciplines and specialities work together with patients or clients, their families, carers, as well as communities to provide the highest standard of care. The study aimed to psychometrically evaluate the construct validity of the CPAT and AITCS-II instruments in measuring the degree of IPC in the Maltese intensive care setting in the university, teaching, general hospital. It also aimed to explore healthcare professionals’ perceptions of the degree of IPC within this setting. A retrospective, cross-sectional, analytical, mixed methods research design was utilised. A sample of 110 eligible healthcare professionals working in the intensive care unit participated in the study, achieving a response rate of 65.1%. Descriptive and inferential statistics, namely internal consistency, correlational analysis, and factorial analysis were performed on the quantitative data. Content analysis was performed on the qualitative data obtained from the CPAT’s three open-ended questions. The results of the present study indicate that overall, both tools provide a good measure of collaborative practice and supports their utilisation for psychometrically validated measurement of collaboration in the Maltese intensive care setting. However, the AITCS-II possibly may be more feasible to investigate IPC in the Maltese intensive care setting. The AITCS-II 23-item scale would make the sample size requirements for the factorial analysis achievable; it is more concise; the overall reliability and construct validity results obtained were satisfactory and correlated well with the CPAT. The participants identified communication, and psychological safety as the main areas for improvement in the IPC. Nonetheless, it is important to acknowledge and consider the limitations of this study when interpreting these findings. Recommendations for health systems management, education, and future research were proposed, including implementing strategies for regular auditing of IPC utilising the AITCS-II and introduction of interventions and interprofessional training to improve collaborative practice. Description: M.Sc. HSM(Melit.)

A change model for a chemotherapy management system : a case study

Sun, 01 Jan 2023 00:00:00 GMT

Title: A change model for a chemotherapy management system : a case study Abstract: Management at Mater Dei Hospital started to introduce a digitalised medicines management system throughout the hospital. A pilot project for the introduction of a Computerised Provider Entry System for cancer chemotherapy at the Oncology Day Ward was being started. This study aimed to develop a change model which best supports the digitalisation of the chemotherapy management system (CMS). The literature showed that a variety of systems were used to support the implementation of digitalised systems in health, and that the implementation of change takes place as a stepwise process. The study was conducted using an exploratory approach ingrained within a pragmatic philosophy. The methodology was designed longitudinally in three phases using quantitative and qualitative methods to collect data. The Organisational Change Readiness Assessment was used to analyse organisational readiness. 35 stakeholders (66%) filled in the questionnaire. Most of the healthcare professionals showed impartiality towards the change effort, with the Working Group (WG) being the most aligned and the Pharmacists least in favour. Observations of the chemotherapy process and interviews with the chairperson of the WG were conducted over a seven-month period, with an outcome evaluation conducted at the end. Process mapping of the sequence and the flow of the steps of the process, and their interactions was conducted. A needs assessment and gap analysis were conducted and these identified issues with the workflow, problems with resources, gaps in training, and lack of stakeholder alignment. The interviews with the chairperson of the WG involved the sharing of results from the study to support decision-making, and gathering of the management perspective along the study period. A change model for the CMS was proposed, consisting of six interconnected aspects in five implementation steps, developed from the literature and the results of this study. Some of the tools identified in the literature were utilised in this study and showed to have worked to carry out evidence-based change management process. The proposed model was found to be applicable for digitalisation of the CMS and the model and tools can be applied for further rollout of the medicines management system across the hospital. The themes identified can also be applied for other digitisation projects. Description: M.Sc. HSM(Melit.)

Effective communication and information retention in orthodontic patients : a randomised controlled trial

Sun, 01 Jan 2023 00:00:00 GMT

Title: Effective communication and information retention in orthodontic patients : a randomised controlled trial Abstract: Introduction: Effective communication is crucial for clinical governance, informed consent, risk management and person-centered care. Treatment outcomes are positively influenced when patients are knowledgeable and take part in shared decision-making. Retention of information is a major challenge in healthcare. The basis of this study is to identify a communication tool that orthodontists could utilise to deliver information in an effective, evidence-based manner to enhance patient compliance, motivation and adherence to instructions. A secondary aim is to identify whether having family members or friends who wore braces influences the knowledge score. Methods: Subjects were recruited from Mater Dei Hospital, Malta. Patients were between 10 and 18 years of age and required fixed appliance treatment. They were randomly allocated into an intervention and control group, 22 patients per group. Each group was given the same verbal and written instructions after the brace was fitted; the intervention group was also shown an audiovisual presentation. All sources of information conveyed the same instructions but in different formats. A questionnaire was used to measure participant knowledge at the first visit (T0) and 6 weeks later (T1). The independent and paired samples t-tests were used to compare the groups. Results: 40 patients completed the study with 4 dropouts. The mean knowledge score of the intervention group was 7.5% more than that of the control group at T0 (p=<.001). There was no statistical difference between the mean scores of the intervention and control group at T1. The intervention group experienced a notable reduction in recall of information in the long-term (p = .13); the mean knowledge score decreased by 6.2%. In the control group, there was no difference in retention of information in the long-term. A higher preliminary finding was associated with a larger reduction in score at follow-up. Having family or friends who wore braces did not significantly affect the mean scores at T0 and T1. Conclusions: Showing patients an audiovisual presentation in addition to verbal and written instructions is effective at improving understanding and retention of information in the short-term. The results suggest that instructions should be repeated at follow-up appointments and a strategy is needed to consolidate the short-term memory of orthodontic patients. Description: M.Sc. HSM(Melit.)

Factors leading to local nursing turnover

Sun, 01 Jan 2023 00:00:00 GMT

Title: Factors leading to local nursing turnover Abstract: The nursing workforce is a critical component of any healthcare system. A shortage of this human resource negatively impacts patients, the economy, and even the nursing workforce itself. This valuable resource is in short supply globally, and in Malta there is a shortage of roughly 10% of the nursing workforce. Therefore, it is of great importance that measures are taken to improve the uptake and retention of nurses. This dissertation aims to elicit and understand the underlying reasons behind local nursing turnover, specifically nurses who voluntarily resign from the nursing profession, in order to provide recommendations for future research and recommendations for measures that can be planned for and undertaken by the management of the nursing profession in Malta. This study utilised the interpretivism paradigm with an inductive, qualitative, phenomenological approach. The target population were nurses employed in the public healthcare system of Malta, who voluntarily resigned from the profession during the period of 2012 to 2022. Seven respondent participants had taken part in semi-structured interviews which had been recorded and transcribed verbatim. Interpretative phenomenological analysis was used to analyse the transcriptions, the findings of which were then discussed alongside the data gathered through a literature review of the same topic. The results of the study had shown that the main factors resulting in the participants’ resignations stemmed from issues with organisational management and leadership. These ranged from inflexibility with working hours, excessive workload and unacknowledged responsibility, to those in leadership roles lacking the experience and aptitude that is required to appropriately manage the specific work environments. These factors had led to the participants reaching unbearable levels of stress and anxiety, feeling unheard, unsupported, undervalued, not respected, and with some reporting that they had features of burn out. This study was undertaken solely by the researcher as part of a Master degree in Management and Leadership in Health Sciences. Ethical approval was sought and granted by the Faculty Research Ethics Committee of the University of Malta. No conflict of interest was present as no funding was received for the research project. Description: M.Sc. HSM(Melit.)