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  • 1.
    Rönnerhag, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. University of South-Eastern Norway, Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, P.O. Box 235, N-3603, Kongsberg, Norway.
    Severinsson, Elisabeth
    University of South-Eastern Norway, Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, P.O. Box 235, N-3603, Kongsberg, Norway.
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women's Health, Division of Health Sciences& Nursing Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    A qualitative evaluation of healthcare professionals' perceptions of adverse events focusing on communication and teamwork in maternity care2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 3, p. 585-593Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to explore healthcare professionals' perceptions of adverse events during childbirth with focus on communication and teamwork.

    BACKGROUND: Inadequate communication, a poor teamwork climate and insufficient team training are harmful to women. Reviews of reported adverse events can be used to develop a safety culture based on preparedness for preventing adverse events and strengthening patient safety.

    DESIGN: Action research principles were used to facilitate the implementation and evaluation of this study.

    METHODS: An interprofessional team of healthcare professionals comprising obstetricians, registered midwives and assistant nurses employed at a labour ward agreed to take part. Data were collected from multistage focus group interviews (March 2016 - June 2016) and analysed by means of interpretative thematic analysis.

    FINDINGS: Two analytical themes based on five sub-themes emerged; Promoting interprofessional teamwork and Building capabilities by involving healthcare professionals and elucidating relevant strategies. The findings reveal the importance of facilitating relationships based on trust and respectful communication to ensure a safe environment and provide safe maternity care.

    CONCLUSION: There is a need for formal and informal support for quality interprofessional teamwork. Research on patient safety may reduce adverse events related to miscommunication and poor teamwork. We recommend different forms of communication and teamwork training in interprofessional teams to increase the ability to provide feedback. Accumulated research is required for the evaluation of evidence-based models in the patient safety context. This article is protected by copyright. All rights reserved.

  • 2.
    Rönnerhag, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. University of South-Eastern Norway, Centre for Women's, Family and Child Health, Department of Nursing and Health Sciences, Faculty of Health Sciences, Kongsberg, Norway.
    Severinsson, Elisabeth
    University of South-Eastern Norway, Centre for Women's, Family and Child Health, Department of Nursing and Health Sciences, Faculty of Health Sciences, Kongsberg, Norway.
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women's Health, Tokyo, Japan.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Qualitative study of women's experiences of safe childbirth in maternity care2018In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 20, no 3, p. 331-337Article in journal (Refereed)
    Abstract [en]

    Few studies have focused on women's childbirth experiences in relation to patient safety. The aim of this study was to explore the meaning of safety as a process phenomenon by outlining women's positive and negative experiences of safety in childbirth. A descriptive explorative design was chosen and 16 interviews were conducted. Qualitative content analysis was used. One main theme emerged: safe childbirth through involvement and guidance, based on four subthemes. The characteristics of women's experiences of safe childbirth included the need to be informed and involved by sharing and receiving trustworthy information. Women's experiences of unsafe childbirth included lack of meaningful and trustworthy information that resulted in feelings of being misled or lulled into a false sense of security. Not being involved evoked feelings of being ignored. In conclusion, this study highlights issues of importance for safe maternity care. The perspectives of childbearing women can contribute to an understanding of how to achieve meaningful improvements to provide safer maternity care.

  • 3.
    Rönnerhag, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. University of South-Eastern Norway, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, P.O. Box 235, N-3603 Kongsberg, Norway.
    Severinsson, Elisabeth
    University of South-Eastern Norway, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, P.O. Box 235, N-3603 Kongsberg, Norway.
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women’s Health, Division of Health Sciences & Nursing Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Risk Management: evaluation of healthcare professionals reasoning about and understanding of maternity care2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1098-1278Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate healthcare professionals' explanations of the prerequisites for safe maternity care and understanding of risk management, including the underlying reasons for decision‐making intended to ensure safe care.Background: Risk management focuses on maintaining and promoting safe care by identifying circumstances that place childbearing women at risk of harm, thus reducing risks.Methods: A hermeneutic action research approach was chosen. Through a series of focus group sessions we uncovered healthcare professionals' explanations of risk management.Results: One overriding theme emerged; The consequences of what managers do or fail to do constitute the meaning of taking responsibility for team collaboration to provide safe care. Inadequate support, resources and staff shortages have consequences, such as inability to concentrate on team communication and collaboration, leading to the risk of unsafe care.Conclusion: Communication constitutes a prerequisite for both team collaboration and risk management. Thus, communication is linked to the ability of managers and healthcare professionals to provide safe care.Implications for Nursing Management: In terms of safety management, nurse managers have a significant role in and responsibility for supporting communication training, developing guidelines and providing the prerequisites for interprofessional team reflection.

  • 4.
    Severinsson, Elisabeth
    et al.
    Buskerud & Vestfold University College, Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Kongsberg, Norway..
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women’s Health, Division of Health Sciences & Nursing, Graduate School of Medicine, Tokyo, Japan..
    Rönnerhag, Maria
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Buskerud & Vestfold University College, Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Kongsberg, Norway..
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Patient Safety, Adverse Healthcare Events and Near-Misses in Obstetric Care: A Systematic Literature Review2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 12, p. 1110-1122Article in journal (Refereed)
    Abstract [en]

    Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses in the context of patient safety. We conducted a search of the published literature from Europe, Australia and the USA in the following databases: Cinahl, Cochrane, Maternity and Infant Care, Ovid, Pro-quest and PubMed, guided by PRISMA procedures. A total of 427 studies were screened, 15 full papers retrieved and nine studies included in the final thematic analysis. The selected papers address a broad spectrum of adverse patient safety events in obstetric care. The themes that emerged were: type of AEs, near-misses and their consequences, strategies to support and improve Patient Safety (PS) and domains related to the WHO Patient Safety competence outcomes. The findings of the first theme were grouped into the following categories: healthcare professionals' perspectives on ethical conflicts, attributing blame and responsibility, and patients' perspectives on lack of trust and involvement, as well as medication errors. The second theme, strategies to support interventions to improve PS, was based on two sub-themes: communicating effectively and gaining competence by learning from adverse events, while the third theme was domains related to the WHO Patient Safety competence outcomes. In conclusion, few studies have examined strategies for managing AEs despite the existence of programmes that target the implementation of changes, such as improved teamwork training. In addition to exploring strategies to make safety a priority for patients and healthcare professionals, it is of the utmost importance to improve communication with patients and between professionals in order to maintain and enhance safety. Efforts by organizations and individuals to continuously develop knowledge about the risk of AEs and the use of best practice guidelines are also essential.

  • 5.
    Severinsson, Elisabeth
    et al.
    University College of Southeast-Norway, Centre for Women’s, Family & Child Health, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, Kongsberg, Norway..
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women’s Health, Division of Health Sciences & Nursing, Graduate School of Medicine, Tokyo, Japan..
    Rönnerhag, Maria
    University West, Department of Health Sciences, Section for nursing - undergraduate level. University College of Southeast-Norway, Centre for Women’s, Family & Child Health, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, Kongsberg, Norway..
    Holm, Anne Lise
    Western Norway University of Applied Sciences, Department of Health Sciences, Haugesund, Norway.
    Hansen, Britt S,
    University College of Southeast-Norway, Centre for Women’s, Family & Child Health, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, Kongsberg, Norway..
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Evidence of Linkages between Patient Safety and Person-Centred Care in the Maternity and Obstetric Context: An Integrative Review2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 3, p. 378-398Article in journal (Refereed)
    Abstract [en]

    The aim was to evaluate the current state of knowledge pertaining to patient safety and its link to person-centred care. The international relevance of patient safety has expanded, as have the models of person-centred care. Inspired by this new trend, we collated and summarized the literature for evidence of the two topics. The study was guided by Russell, Whittemore and Knafl's integrative review framework. An electronic database search was conducted for relevant articles from 2005 to 2016. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The structure and process of the evaluation of the evidence are described and the findings interpreted by means of a thematic synthesis. One theme emerged: trustful, safe communication in the relationship between the patient, family members and healthcare professionals and two domains; safety culture and multidisciplinary capacity building. The dominant dimension in the safety culture domain is respectful communication, which implies sharing experiences that lead to a sense of control during labour and birth and is related to the women's feeling of personal capacity. The dominant dimensions in the multidisciplinary capacity building domain are collaborative teamwork, coordination and risk management, knowledge sharing and patient-centred communication. In conclusion, to enhance patient safety, it is necessary to develop patient-focused, evidence-based skills and guidelines as well as a supportive organization. Due to their interaction with patients, midwives' communication competence on the part of midwives is essential for supporting the birth and fulfilling the women's needs and expectations.

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