Volume 33, Issue 123 (April 2020)                   IJN 2020, 33(123): 73-83 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Heidari H, Khaledifar A. The Necessities and Requirements of the Pediatric Angiography Ward from the Perspective of the Healthcare Team: A Qualitative Study. IJN 2020; 33 (123) :73-83
URL: http://ijn.iums.ac.ir/article-1-3176-en.html
1- School of Nursing and Midwifery, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran (Corresponding author) Tel: 0989133822402 Email:heidari.h@skums.ac.ir
2- School of Medicine, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
Abstract:   (2891 Views)
Background & Aims: Pediatric angiography has been widely used for the diagnosis and treatment of congenital heart disorders in children over the past two decades. The work environment of the nurses of pediatric intensive care units is highly stressful due to various technical and medical equipment and patients with life-threatening diseases. In order to improve special pediatric care environments, attention must be paid to the experiences and opinions of the nurses employed in these units. To this end, the prioritization of the health of workplace and applying multidimensional approaches to the health promotion of the workplace are paramount. Considering the teamwork involved in patient care and treatment and increased number of beds in intensive care units, it is critical to evaluate the perceptions of physicians and nurses regarding the aspects of care in intensive care units. The improvement of the performance of pediatric critical care nurses and attention to their experiences and viewpoints are also essential in this regard. To this end, the prioritization of the health of workplace and applying multidimensional approaches to the health promotion of the workplace are paramount. The use of pediatric angiography has increased in the past two decades. In addition, the differences in the culture, environment, and education of nurses in pediatric intensive care units, along with the differences in the hospitalized patients further emphasize on the necessity of qualitative research. However, most of the studies in this regard have been performed with a quantitative approach, while only qualitative research could determine the dimensions of the perceptions of the healthcare team. To date, no qualitative studies have assessed the experiences of the healthcare team in the pediatric angiography ward. The present study aimed to elaborate on the necessities and requirements of the pediatric angiography ward from the perspective of the healthcare team.
Materials & Methods: This study was conducted using the qualitative content analysis approach in 2018. The sample population included 20 subjects, including nine nurses, four radiologists, and seven cardiologists, who were selected via purposeful sampling from the angiography unit of Hajar Hospital in Shahrekord, Iran. The inclusion criteria were the nurses and physicians with one year of work experience in the angiography or cardiology ward and willingness to participate in the study, and the exclusion criterion was unwillingness to participate. The duration of the interviews was 35-60 minutes, and the recordings were performed in accordance with ethical principles. Data collection and interviews continued until reaching data saturation. Data collection and analysis continued for four months. The semi-structured, individual interviews were initiated with the nurses and physicians with an open question ("Please explain your experiences of working in the pediatric angioplasty ward."/"What challenges have you faced in performing pediatric angiography?") The interviews continued with probing questions ("Please explain further."/"Please set an example.") The obtained data were analyzed using the qualitative content analysis method. After the researcher listened to the recorded interviews several times, he was immersed in the data to obtain an overview of the interviews. All the interviews were transcribed word-for-word, so that the words containing the key concepts would be highlighted and the codes would be extracted. After extracting the concepts and codes from important sentences and paragraphs, they were classified into categories based on the similarities and differences, and the categories were reduced to a smaller number of categories based on their correlations. In order to maximize the diversity of the participants, the research units were selected from the nurses, physicians (pediatric cardiologists), and radiologists engaged in the angiography ward. To ensure the accuracy and reliability of the research findings, the four criteria of credibility, dependability, transferability, and conformability were considered. To observed ethical considerations, a letter of recommendation was obtained from the Vice-Chancellor of Research of Shahrekord University of Medical Sciences. In addition, written informed consent and permission to record the interviews were obtained from the subjects prior to participation.
Results: The mean age of the nurses was 34 years, and the mean work experience in the angiography ward was five years. The mean age of the radiologists was 31.5 years, and the mean work experience in the angiography ward was three years. The mean age of the pediatric cardiologists was 45 years, and the mean work experience in the angiography ward was five years. Data analysis yielded the three categories of the sensitivity of the ward, the necessity of the proper use of specialized equipment, and the need for education and skills training. The category of the sensitivity of the ward had three subcategories of the special conditions of the patients, sterilization of the angiography environment, and the need to become familiarized with the ward. The category of the proper use of specialized equipment had two subcategories of expensive equipment and management regulations of the maintenance of specialized equipment. The category of the need for education and skills training had two subcategories of the need for knowledge skills and the need for communication skills.
Conclusion: The three most important findings of this study were the need for familiarity and proper use of specialized equipment and the necessity of education and skills training, which are like a golden treasure, the key to which is in the hands of hospital managers and officials. The training of the healthcare team in the angiography ward is a gradual and continuous process. Among the required skills for practice in the angiography ward are having adequate knowledge and the ability to properly communicate with the patients and their companions and the ability to use the specialized equipment correctly and appropriately, which could be achieved through the implementation of communication and counseling training courses, training on the use of specialized equipment, and the necessary preparations for the personnel of this ward. Considering the sensitivity of the angiography ward, the criticality of the applied procedures in the ward, and important issues such as clinical governance and accreditation, special attention should be paid to educational need assessment in order to implement proper interventions by hospital managers and health planners in terms of the training and skills of the personnel.
Full-Text [PDF 812 kb]   (769 Downloads)    
Type of Study: کیفی | Subject: nursing
Received: 2020/01/18 | Accepted: 2020/04/21 | Published: 2020/04/21

References
1. Mobini-Bidgoli M, Taghadosi M, Gilasi H, Farokhian A. The effect of hand reflexology on anxiety in patients undergoing coronary angiography: A single-blind randomized controlled trial. Complementary Therapies in Clinical Practice. 2017;27:31-6. [DOI:10.1016/j.ctcp.2017.01.002] [PMID]
2. Le Roy J, Vernhet Kovacsik H, Zarqane H, Vincenti M, Abassi H, Lavastre K, Mura T, Lacampagne A, Amedro P. Submillisievert multiphasic coronary computed tomography angiography for pediatric patients with congenital heart diseases. Circulation: Cardiovascular Imaging. 2019;12(2):e008348. [DOI:10.1161/CIRCIMAGING.118.008348]
3. van der Stelt F, Siegerink SN, Krings GJ, Molenschot MM, Breur JM. Three-dimensional rotational angiography in pediatric patients with congenital heart disease: a literature review. Pediatric cardiology. 2019;40(2):257-64. [DOI:10.1007/s00246-019-02052-z] [PMID] [PMCID]
4. Hickey EJ, Caldarone CA, Blackstone EH, Williams WG, Yeh Jr T, Pizarro C, Lofland G, Tchervenkov CI, Pigula F, McCrindle BW, Congenital Heart Surgeons' Society. Biventricular strategies for neonatal critical aortic stenosis: high mortality associated with early reintervention. J Thorac Cardiovasc Surg. 2012;144(2):409-17. [DOI:10.1016/j.jtcvs.2011.09.076] [PMID]
5. Aiken LH, Sloane D, Griffiths P, Rafferty AM, Bruyneel L, McHugh M, Maier CB, Moreno-Casbas T, Ball JE, Ausserhofer D, Sermeus W. Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ qual saf. 2017;26(7):559-68. [DOI:10.1136/bmjqs-2016-005567] [PMID] [PMCID]
6. Arrogante O, Aparicio-Zaldivar E. Burnout and health among critical care professionals: The mediational role of resilience. Intens Crit Care Nurs. 2017;42:110-5. [DOI:10.1016/j.iccn.2017.04.010] [PMID]
7. Jansson AB, Engström Å. Working together: critical care nurses experiences of temporary staffing within Swedish health care: A qualitative study. Intens Crit Care Nurs. 2017;41:3-10. [DOI:10.1016/j.iccn.2016.08.010] [PMID]
8. Currey J, Eustace P, Oldland E, Glanville D, Story I. Developing professional attributes in critical care nurses using Team-Based Learning. Nurse Educ Pract. 2015;15(3):232-8. [DOI:10.1016/j.nepr.2015.01.011] [PMID]
9. Güner P, Hiçdurmaz D, Yıldırım NK, İnci F. Psychosocial care from the perspective of nurses working in oncology: A qualitative study. Eur J Oncol Nurs. 2018;34:68-75. [DOI:10.1016/j.ejon.2018.03.005] [PMID]
10. Cho E, Sloane DM, Kim EY, Kim S, Choi M, Yoo IY, Lee HS, Aiken LH. Effects of nurse staffing, work environments, and education on patient mortality: an observational study. Int J Nurs Stud. 2015;52(2):535-42. [DOI:10.1016/j.ijnurstu.2014.08.006] [PMID] [PMCID]
11. Wang S, Liu Y. Impact of professional nursing practice environment and psychological empowerment on nurses' work engagement: test of structural equation modelling. J Nurs Manag. 2015;23(3):287-96. [DOI:10.1111/jonm.12124] [PMID]
12. Ulrich BT, Lavandero R, Woods D, Early S. Critical care nurse work environments 2013: a status report. Critical care nurse. 2014;34(4):64-79. [DOI:10.4037/ccn2014731] [PMID]
13. Rezaei M, Ghiasvandian S, Zakeri Moghadam M. Comparison of physicians' and nurses' perceptions of futile care in intensive care units of Shiraz University of Medical Sciences hospitals. Iranian Journal of Cardiovascular Nursing. 2018;7(1):6-13.
14. Afshar M, Gandomani HS, Alavi NM. Exploring Barriers to Promotion of Professional Empowerment from the Perspectives of Nurses working in Surgical Ward of Kashan Shahid Beheshti hospital: A Qualitative Study. Iranian Journal of Rehabilitation Research in Nursing (IJRN). 2018; 5(2):1-9.
15. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-15. [DOI:10.1111/j.1365-2648.2007.04569.x] [PMID]
16. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12. [DOI:10.1016/j.nedt.2003.10.001] [PMID]
17. Henwood S, Booth L. On becoming a consultant: a study exploring the journey to consultant practice. Radiography. 2016;22(1):32-7. [DOI:10.1016/j.radi.2015.03.013]
18. Kol E, Ilaslan E, Turkay M. Training needs of clinical nurses at an university hospital in Turkey. Nurse Educ Pract. 2017;22:15-20. [DOI:10.1016/j.nepr.2016.11.004] [PMID]
19. Tuncay S, Gunay U. The effects of playing digital games on the pain levels and mobility states of children post-angiography: A randomized controlled trial. Annals of Medical Research. 2019;26(9):1731-6. [DOI:10.5455/annalsmedres.2019.06.359]
20. Johnson C. Design, organization and staffing of the intensive care unit. Surgery (Oxford). 2018;36(4):159-65. [DOI:10.1016/j.mpsur.2018.01.007]
21. Kim EK, Shin S. Teaching efficacy of nurses in clinical practice education: A cross-sectional study. Nurse Educ Today. 2017;54:64-8. [DOI:10.1016/j.nedt.2017.04.017] [PMID]
22. Expósito JS, Costa CL, Agea JL, Izquierdo MD, Rodríguez DJ. Ensuring relational competency in critical care: Importance of nursing students' communication skills. Inten Crit Care Nurs. 2018;44:85-91. [DOI:10.1016/j.iccn.2017.08.010] [PMID]
23. Butler R, Monsalve M, Thomas GW, Herman T, Segre AM, Polgreen PM, Suneja M. Estimating time physicians and other health care workers spend with patients in an intensive care unit using a sensor network. Am J Med. 2018;131(8):972-e9. [DOI:10.1016/j.amjmed.2018.03.015] [PMID]
24. Arslanian-Engoren C, Scott LD. Clinical decision regret among critical care nurses: A qualitative analysis. Heart & Lung. 2014;43(5):416-9. [DOI:10.1016/j.hrtlng.2014.02.006] [PMID]
25. Lobo VM, Ploeg J, Fisher A, Peachey G, Akhtar-Danesh N. Critical care nurses' perceptions of the outcomes of working overtime in Canada. Nursing outlook. 2017;65(4):400-10. [DOI:10.1016/j.outlook.2016.12.009] [PMID]
26. Robaee N, Atashzadeh-Shoorideh F, Ashktorab T, Baghestani A, Barkhordari-Sharifabad M. Perceived organizational support and moral distress among nurses. BMC nursing. 2018;17(1):1-7. [DOI:10.1186/s12912-017-0270-y] [PMID] [PMCID]
27. Gouzou M, Karanikola M, Lemonidou C, Papathanassoglou E, Giannakopoulou M. Measuring professional satisfaction and nursing workload among nursing staff at a Greek Coronary Care Unit. Revista Esc Enfer USP. 2015;49(SPE):15-21 [DOI:10.1590/S0080-6234201500000003] [PMID]

Add your comments about this article : Your username or Email:
CAPTCHA

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2015 All Rights Reserved | Iran Journal of Nursing

Designed & Developed by : Yektaweb