Runa Lazzarino’s research while affiliated with University of Oxford and other places

Background Sepsis is a common cause of serious illness and death. Sepsis management remains challenging and suboptimal. To support rapid sepsis diagnosis and treatment, screening tools have been embedded into hospital digital systems to appear as digital alerts. The implementation of digital alerts to improve the management of sepsis and deterioration is a complex intervention that has to fit with team workflow and the views and practices of hospital staff. Despite the importance of human decision-making and behavior in optimal implementation, there are limited qualitative studies that explore the views and experiences of health care professionals regarding digital alerts as sepsis or deterioration computerized clinician decision support systems (CCDSSs). Objective This study aims to explore the views and experiences of health care professionals on the use of sepsis or deterioration CCDSSs and to identify barriers and facilitators to their implementation and use in National Health Service (NHS) hospitals. Methods We conducted a qualitative, multisite study with unstructured observations and semistructured interviews with health care professionals from emergency departments, outreach teams, and intensive or acute units in 3 NHS hospital trusts in England. Data from both interviews and observations were analyzed together inductively using thematic analysis. Results A total of 22 health care professionals were interviewed, and 12 observation sessions were undertaken. A total of four themes regarding digital alerts were identified: (1) support decision-making as nested in electronic health records, but never substitute professionals’ knowledge and experience; (2) remind to take action according to the context, such as the hospital unit and the job role; (3) improve the alerts and their introduction, by making them more accessible, easy to use, not intrusive, more accurate, as well as integrated across the whole health care system; and (4) contextual factors affecting views and use of alerts in the NHS trusts. Digital alerts are more optimally used in general hospital units with a lower senior decision maker:patient ratio and by health care professionals with experience of a similar technology. Better use of the alerts was associated with quality improvement initiatives and continuous sepsis training. The trusts’ features, such as the presence of a 24/7 emergency outreach team, good technological resources, and staffing and teamwork, favored a more optimal use. Conclusions Trust implementation of sepsis or deterioration CCDSSs requires support on multiple levels and at all phases of the intervention, starting from a prego-live analysis addressing organizational needs and readiness. Advancements toward minimally disruptive and smart digital alerts as sepsis or deterioration CCDSSs, which are more accurate and specific but at the same time scalable and accessible, require policy changes and investments in multidisciplinary research.

A correction to this paper has been published: https://doi.org/10.1007/s10943-021-01274-x

The webinar is part of the IENE 8 project "Empowering Migrants and Refugees with Parenting Skills". Visit http://ienerefugeehub.eu/iene8/ for more information. Here is the link to register for the webinar room: https://tinyurl.com/y57xaytk or scan the QR code. The webinar will start at 13:00 (UK Time) sharp. Please make sure you login into the room at least 15/20 minutes before to make sure you have all the necessary software installed. Have your questions ready for the discussion session! The zoom link will be emailed the day before the webinar. You can also follow the webinar on your mobile phone by downloading the free Zoom App and using the above link. For more instructions, please visit: https://zoom.us/download Scan this QR code to register! The full webinar can be watched at the following address: https://www.play.mdx.ac.uk/media/1_t5xcpdtn.

Spiritual support for hospitalised COVID-19 patients during March to May 2020

Aim: To explore nursing and midwifery managers' views regarding obstacles to compassion-giving across country cultures. Background: The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking. Methods: Cross-sectional, exploratory, international online survey involving 1 217 participants from 17 countries. Managers' responses on open-ended questions related to barriers for providing compassion were entered and thematically analysed through NVivo. Results: Three key themes related to compassion-giving obstacles emerged across countries: 1. related to the managers' personal characteristics and experiences; 2. system-related; and 3. staff-related. Conclusions: Obstacles to compassion-giving among managers vary across countries. An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important. Implications for nursing practice and policy: Nursing mangers should wisely use their power by adopting leadership styles that promote culturally competent and compassionate workplaces with respect for human rights. Policymakers should identify training and mentoring needs to enable the development of managers' practical wisdom. Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system-related obstacles to compassion-giving.

We believe that a curriculum designed to promote culturally competent and compassionate support to migrant and refugee families in transit should be based on respect, equity, compassion, cultural competence, courage, social skills, flexibility, and tolerance. The delivery of the curriculum should build on the knowledge and skills which both health workers and parents already have; it should also encourage them to be reflexive, self-compassionate, and hopeful in the challenging situations they find themselves. They are also invited to think of themselves as example through role modelling and coaching

The IENE8, like all the previous IENE projects, is informed by the Papadopoulos, Tilki, and Taylor Model. For this reason, it is imperative that an understanding of the structure and main constructs of the model which is provided here (Papadopoulos 2006). The IENE1 project modified the PTT model following a needs analysis of nurses in seven European countries. IENE6 developed a Knowledge Hub, with additional Information and Resource, and Support and Training for health workers and volunteers providing emotional/psychological support to migrant and refugees. These previous works are also feeding into IENE8. Therefore, the PPT/IENE model is also included in this report (http://ieneproject.eu/learning.php).