How Was It For You? The Patients Experience


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Anne McMahon
Waitemata District Health Board

(P21, Thursday 27, Civic Room 1, 10.30)

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How Was It For You? The Patients Experience

  1. 1. HOW WAS IT FOR YOU?The patient experience Anne McMahon Mark Cranswick Waitemata District Health Board Auckland, New Zealand
  2. 2. “Hoisting is not inherently undignified,let alone inherently inhuman ordegrading ... hoisting can facilitatedignity, comfort, safety andindependence. It all depends on thecontext”. Justice Munby 2003 High Court of England & Wales (cited in Alexander 2009)
  3. 3. Occupational Therapy – Code of Ethics Occupational Therapists have the responsibility always to promote and protectthe dignity, privacy, autonomy and safety of all people with whom they come in contact in their professional practice
  4. 4. Code of Professional Conduct for NursesValues Statement 1:“3. Respect - for individual needs, beliefs and values includes culturally informed and appropriate care, and the provision of as much comfort, dignity, privacy and alleviation of pain and anxiety as possible.”
  5. 5. Pain has become the 5th vital sign, after pulse, respiration, blood pressure, and temperatureEmotional distress (including anxiety) should be considered as the 6th vital sign
  6. 6. Risk indicators LBP-SL 12/12N=2164 working nurses and midwivesRisk indicators LBP-SL 12/12Fear of movementPassive copingFrequent manual handlingSevere or radiating pain Anna Dawson - PAIN 2011
  7. 7. ObjectiveTo explore the views of patients whose involvement in a hospital setting is facilitated by either slide sheets or hoist and sling
  8. 8. Themes We StudiedAnxiety and fear SatisfactionFeeling safe Being informedFeeling Exposed TimelyDignity Respect
  9. 9. Phenomenology Phenomenological approaches are based in a paradigm of personal knowledge and subjectivity andemphasise the importance of personal perspective and interpretation
  10. 10. DemographicsN= 65Female 40Male 25Mean age 74.7 yearsRange 19-94 yearsMean age Female 79.6 yearsMean age Male 66.2 years
  11. 11. MethodologySlide sheets 33Hoist 32
  12. 12. BMIUnderweight 7%Healthy 33%Overweight 23%Obese 37%
  13. 13. HoistInformed and involved 100%Feeling safe 93%Maintaining dignity 93%Satisfaction 93%Timeliness 93%Respect 86%Not exposed 80%Not anxious 73%
  14. 14. Themes Exposure / Dignity / RespectThere was a lack of privacy – I likened it to having a baby (89 yr female)I felt it was my decision. I felt I could say yes or no if necessary (26yr male)I felt uncovered but just so happy to get into the chair to see outside the room. A good feeling (72 yr female)I had 2 female nurses and I felt I needed more protection, it was uncomfortable. Best to have underwear on beforehand (62yr male)
  15. 15. Themes Safety / RushedAt times I need to put myself in the care of others – these things are necessary (62yr male)A necessary item. Better than being man-handled(53yr male)I’d rather be hoisted than lifted by people (77yr male)The nurses were prepared well, they knew their rules, kept me in the picture (62yr male)Everything explained, machine shown to you. The sling looked like a flying frog (65yr female)
  16. 16. Themes AnxietyI know the hoist was doing it … it all depends on whether you trust the person who’s doing it (93yr female)The first time it was frightening. It gets better the more it happens. I was frightened I might fall and not be safe (72yr female)I knew I was going to sit out in the chair .. every time they move me I wonder what they are doing (93yr female)
  17. 17. Slide SheetsRespect 100%Satisfaction 100%Safe 93%Dignity 93%Not exposed 89%Timeliness 86%Informed and involved 79%Not anxious 59%
  18. 18. Themes Exposure / Dignity / RespectI think I was covered, but I would not have worried as I was out of my comfort zone and also out of control (86yr female)I felt a little uncomfortable as the curtains were not around and there were male patients sharing the ward (74yr female)I had to remind the staff to pull the curtains around. I felt the staff kept forgetting (77yr female)Staff hoist vs. slide sheets and I was given a choice. I preferred the idea of not being hoisted … felt that would be too out of balance (86yr male)
  19. 19. Themes Safety / RushedIt was the best for me otherwise I wouldn’t be able to move (72yr female)I wanted them used for ease of handling for both myself and staff (71yr male)It was good for me, I wouldn’t want to be lifted (78yr male)It’s much better than being pulled up and down – especially you girls with your nails (65yr male)At times I felt rushed. I grabbed a nurse’s breast because I wanted her to slow down (65yr female)
  20. 20. Themes AnxietyIn retrospect I realised staff considered my feelings but at the time I was so unused to any personal interference, everything was uncomfortable (86 yr male)Although they explained the procedure it was unfamiliar. I thought I was going to be bundled up with the sheets (86 yr male)I think slide sheets are a good idea but I wasn’t informed why it was happening prior – I thought I was being moved somewhere else (74 yr visually impaired, transferred at night)
  21. 21. What Next? Use outcomes as training content indicators Consider retrospective study and sub groups Apply similar audit to staff
  22. 22. Contact