Leadership plays a key role in preventing healthcare-associated infections. Through interviews at multiple hospitals, the study found that effective leaders in infection prevention displayed behaviors like vision, knowledge, and strong communication skills. While senior executives can be leaders, the study observed that roles like epidemiologists, nurses, and quality managers also demonstrated transformational leadership through inspiring staff and cultivating a culture of clinical excellence. The findings suggest leadership broadly defined and at different levels contributes significantly to hospitals' ability to implement infection control practices.
Hello members...this powerpoint deals with A journal presentation, that aims at highlighting the "Efficacy & safety of Lacosamide in painful diabetic neuropathy patients".
This also elucidates a model of "Journal club presentation" for interested students.
Happy reading!!
:)
What is Cohort?
Indication and Elements of Cohort Study.
What is Relative risk and Attributable risk, and its interpretation?
Advantages & disadvantages of Cohort study.
Difference between Case control & Cohort study.
Journal club, journal club presentation, public health, medicine, critical appraisal, journal, epidemiology, nursing, health care, health management, health system
Hello members...this powerpoint deals with A journal presentation, that aims at highlighting the "Efficacy & safety of Lacosamide in painful diabetic neuropathy patients".
This also elucidates a model of "Journal club presentation" for interested students.
Happy reading!!
:)
What is Cohort?
Indication and Elements of Cohort Study.
What is Relative risk and Attributable risk, and its interpretation?
Advantages & disadvantages of Cohort study.
Difference between Case control & Cohort study.
Journal club, journal club presentation, public health, medicine, critical appraisal, journal, epidemiology, nursing, health care, health management, health system
A cross-sectional study is a descriptive study in which disease and exposure status are measured simultaneously in a given population.
It measures
the prevalence of health outcomes(also called prevalence study)
or determinants of health,
or both,
In a population at a point in time or over a short period.
When the investigator draws a sample out of the study population of interest and examines all the subjects to detect
those having the disease/outcome
and those not having this disease/outcome of interest.
At the same time, finds out whether or not they have the presence of
the suspected cause (exposure)
(or give a History of such exposure in the past),
is called the Cross-sectional analytic study.
journal club, journal club presentation, public health, medicine, health care, epidemiology, health system, health policy, health management, health economics, critical appraisal, online journal club, article appraisal, bachelor of public health, nursing, allied health sciences
Different types of epidemiological methods
Salient features of case control study
Steps for conducting case control study
Matching
Odds ratio
Bias in case control study
Advantages & disadvantages in case control study
Ethical issues in medicine and research:Special reference to IndiaJishnu Lalu
A detailed discussion on Ethical consideration concerning physician, patient, co-workers and research. It also discusses publication ethics and Ethics in India
Concept of Association, Causation and Correlation
Association - Spurious, Indirect & Direct
Multi-factorial causation
Guidelines for Judging causality
Additional Criteria for Judging causality
Taking Occupational Health to the Unorganized Sector- Challenges and Opportun...Dr Rajiv Kumar Jain
Occupational Health and Safety cover for the unorganized sector can well be said as nonexistent.
Of the total employed population in the country during 2007 about 17 per cent was in the organized sector and 83 per cent is in the unorganized sector.
As per the International Labour Organisation (ILO) estimates, nearly 2 lakh workers die annually and about 1200 lakh are injured. Nearly 50 percent of these deaths and injuries occur in developing countries.
As far as occupational diseases are concerned, the absence of any national level statistics is partially compensated with independent studies reporting existence of many occupational diseases.
The overwhelming target population to be covered in the unorganised sector for the improvement of the safety and health status is a Herculean task to be achieved in a vast country like India. special cell with executive power attached to a government department in the Ministry need to be formed and this could be part of the proposed National Board of Occupational Safety and Health. In fact, the Board will be formed under a Government Legislation on Occupational Safety and Health (Safety and Health at Work Act), which the government is proposing to enact. This Board will be an apex body at national level to deal with matters connected with OSH issues of workers in all
sectors or economy and will assist the Government of India in the implementation of the National Policy on Occupational Safety and Health.
A cross-sectional study is a descriptive study in which disease and exposure status are measured simultaneously in a given population.
It measures
the prevalence of health outcomes(also called prevalence study)
or determinants of health,
or both,
In a population at a point in time or over a short period.
When the investigator draws a sample out of the study population of interest and examines all the subjects to detect
those having the disease/outcome
and those not having this disease/outcome of interest.
At the same time, finds out whether or not they have the presence of
the suspected cause (exposure)
(or give a History of such exposure in the past),
is called the Cross-sectional analytic study.
journal club, journal club presentation, public health, medicine, health care, epidemiology, health system, health policy, health management, health economics, critical appraisal, online journal club, article appraisal, bachelor of public health, nursing, allied health sciences
Different types of epidemiological methods
Salient features of case control study
Steps for conducting case control study
Matching
Odds ratio
Bias in case control study
Advantages & disadvantages in case control study
Ethical issues in medicine and research:Special reference to IndiaJishnu Lalu
A detailed discussion on Ethical consideration concerning physician, patient, co-workers and research. It also discusses publication ethics and Ethics in India
Concept of Association, Causation and Correlation
Association - Spurious, Indirect & Direct
Multi-factorial causation
Guidelines for Judging causality
Additional Criteria for Judging causality
Taking Occupational Health to the Unorganized Sector- Challenges and Opportun...Dr Rajiv Kumar Jain
Occupational Health and Safety cover for the unorganized sector can well be said as nonexistent.
Of the total employed population in the country during 2007 about 17 per cent was in the organized sector and 83 per cent is in the unorganized sector.
As per the International Labour Organisation (ILO) estimates, nearly 2 lakh workers die annually and about 1200 lakh are injured. Nearly 50 percent of these deaths and injuries occur in developing countries.
As far as occupational diseases are concerned, the absence of any national level statistics is partially compensated with independent studies reporting existence of many occupational diseases.
The overwhelming target population to be covered in the unorganised sector for the improvement of the safety and health status is a Herculean task to be achieved in a vast country like India. special cell with executive power attached to a government department in the Ministry need to be formed and this could be part of the proposed National Board of Occupational Safety and Health. In fact, the Board will be formed under a Government Legislation on Occupational Safety and Health (Safety and Health at Work Act), which the government is proposing to enact. This Board will be an apex body at national level to deal with matters connected with OSH issues of workers in all
sectors or economy and will assist the Government of India in the implementation of the National Policy on Occupational Safety and Health.
Similar to Journal Club Presentation on The Importance of Leadership in Preventing Healthcare-Associated Infection: Results of a Multisite Qualitative Study
HIT Use in Primary Care Practices: Understanding and Eliminating Disparity UCLA CTSI
UCLA CTSI and University of Minnesota Cross-Institutional Award Projects
Principal Investigators: Hector Rodriguez (UCLA) and William Riley (University of Minnesota)
Large-scale federal investments in health information technology (HIT) are intended to spur health care providers and organizations to share patient information to better coordinate and improve quality of care. However, the uptake of HIT has lagged in ambulatory care settings that care for high proportions of low-income patients. Our pilot study seeks to generate knowledge about facilitators and barriers to the spread of electronic health information exchange (HIE) for improving quality of care among underserved populations. We have established partnerships with two health care organizations: Citrus Valley Health Partners (CVHP), a provider network serving many underserved patients in the East San Gabriel Valley, Calf., and the Federally Qualified Health Center Urban Health Network (FUHN), a group of ten clinic organizations serving the Minneapolis-St. Paul area. We are conducting key informant interviews of physicians, front office staff, IT personnel, and executives. Through these interviews, we are learning about the barriers to electronic exchange of health information within the clinics and practices, between these sites, and at city-wide or regional levels. This multi-level framework elucidates the opportunities and challenges for ambulatory care practices serving underserved populations in adopting and sustaining HIT.
Dr. Dorene Balmer PhD (Columbia University) is an expert on Qualitative Research methods and speaks through this webinar on Qualitative Methods, particularly through her own study on Resident Education.
RUNNINGHEADER:PROJECTANALYSIS 1
Corruption 2
“Project Analysis on Corruption”BADM440-1404A-01
Quesadra Dynell Goodrum
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Instructor: Jose Perez
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Table of Contents
Sample Population 3
Questionnaires 4
Oral Interviews 4
Observation 4
Data Analysis and Measurement Strategy 4
This ethical consideration will be built on the following basic principles of ethical practice 5
a) Informed Consent 6
b) Beneficence 6
c) Justice 7
References 8
Sample Population
The success of this research depends on the sample population that I choose to work with. I intend to obtain information about a population and have settled for only selected members of the population to be questioned. Contacting, questioning, and obtaining information from a large population, such as all of the households residing in Colorado, is extremely expensive, difficult, and time consuming. A properly designed probability sample, however, provides a reliable means of inferring information about a population without examining every member or element. When properly conducted, a probability sample of provides very reliable information with very small margin of error for the whole population in Colorado.
Working with a sample size of 300 respondents, the smaller sampling operation lends itself to the application of more rigorous controls, thus ensuring better accuracy. This calls for rigorous controls to reduce noncomplying errors such as interviewer bias and mistakes, nonresponse problems, questionnaire design flaws, and data processing and analysis errors.
The sampling methodology used for this research is the nonprobability sampling. In this case, when discussing the results of a nonprobability sample, I will limit myself to findings of the persons sampled. The advantage of nonprobability sampling is the ease in which it can be administered. They tend to be less complicated and less time consuming.
Judgmental sampling is the type of nonprobability sampling employed for this study. In judgmental or purposive sampling, I would employ my own "expert” judgment about who to include in the sample frame. Prior knowledge and research skill I possess would be instrumental are in selecting the respondents or elements to be sampled.
Data Analysis
The data collection procedures included the following:Questionnaires
This involved the administering of organization questionnaires to staff members working in the organizations within the study area. Oral Interviews
This method involved collection of data through face to face interaction with organizations managers and employees. This was to gain insight in the effect of corruption on organizations. Observation
Observation is basic to collecting data on the current state of the study area. It was also used in verifying information collected using the questionnaires proceeds observations as a method of data collection also serves to increase the range of relevance and rel.
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4. Introduction
• Peter Drucker famously stated that “management is doing
things right; leadership is doing the right things.”
• “Manager manages things ,leaders lead people.”
• It is necessary to be good leader first to be a good manager.
4
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5. Definition of leadership
• The leadership is defined as “influence, that is, the art or
process of influencing people so that they will strive willingly
and enthusiastically toward the achievement of group goals”-
D.C.Joshi
5
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6. CHARACTERISTICS OF LEADERSHIP
• Leader must have followers
• It is working relationship between leader and followers
• Purpose is to achieve some common goal or goals
• A leader influences his followers willingly not by force
• Leadership is exercised in a given situation
• Leadership is a power relationship
• It is a continuous process
6
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7. Leadership Styles
• There are various styles the leaders adopt; these styles may be practiced
by different leaders and also by the same leader in different situations:
1. Situational Leadership
• Situational leaders adapt their leadership style to individual situations.
• This type of leadership is based on a relationship between the leader’s
supportive and directive behaviour and the follower’s levels of
development.
• In situational leadership the context shapes how the leader behaves.
Example:
7
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Mahatma Gandhi
8. 2.Transformational Leadership
• Transformational leaders are less relational and emotional in their
interactions with followers.
• They thrive on developing and communicating a vision and
empowering followers to embrace that vision.
• They have and share a vision for what an organisation should and
could be. This type of leader develops others to exceed their own
self-interests for a higher purpose.
• Examples:
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Nelson Mandela Mother Teresa
9. 3.Transactional Leadership
• Transactional leaders are more focused on the analytical
aspects of their role.
• This includes evaluation, measurement, and standardization
aligned with performance.
• These leaders function within a clear chain of command,
motivating their followers through reward and punishment.
• Example:
6/22/2021 9
Bill Gates
10. Hospital-Acquired Infections (HAI)
• HAI continue to be a source of great medical and economical
strain for clinics and facilities across the world.
• A hospital-acquired infection— also called “nosocomial
infection (NI) ” can be defined as: -
• An infection acquired in hospital by a patient who was
admitted for a reason other than that infection. - An infection
occurring in a patient in a hospital or other health care facility
in whom the infection was not present or incubating at the
time of admission.
10
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11. Characteristic of HAI
• For a HAI, the infection must occur:
Up to 48 hours after hospital admission
Up to 3 days after discharge
Up to 30 days after an operation
• In a healthcare facility when someone was admitted for
reasons other than the infection
• Ideally, it should be less than 1-2%
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12. Hospital Acquired Infection Rate
• HAI Rate = (i / d)×100 Where,
• i = Total Number of Hospital Acquired Infections in a given
period
• d = Total Number of Discharges (Including Deaths) in a given
period
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13. Types of HAI
• Hospital-acquired infections are caused by viral, bacterial, and
fungal pathogens.
• The most common types are bloodstream infection (BSI),
pneumonia (eg, ventilator-associated pneumonia [VAP]),
urinary tract infection (UTI), and surgical site infection (SSI).
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14. Implications of HAIs
• HAIs not only threaten the patients' health and life but also
bring additional economic burden to the patients
and healthcare system including direct economic loss and
prolonged hospitalization.
• Total hospital length of stay (LOS) is known to be prolonged by
the occurrence of HAI.
•
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15. Leadership in HAI
• An IPC leader should seek to continuously improve
implementation of IPC programmes and all core components.
As a leader these soft skills can be used to influence
multimodal strategies to:
• Build a system (including infrastructures) that supports IPC
practices.
• Teach others about IPC.
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16. • Check that the organization is doing the right thing at the right
time.
• Sell it to others and keep them interested in adopting and
maintaining excellent IPC practices.
• Live it by embedding excellent IPC practices across
organization’s culture.
16
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17. Qualitative Research Methods
• Qualitative research involves collecting and analyzing non-
numerical data (e.g., text, video, or audio) to understand
concepts, opinions, or experiences. It can be used to gather in-
depth insights into a problem or generate new ideas for
research.
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18. Types of Qualitative method
1.Phenomenological Method
• Describing how any one participant experiences a specific event is
the goal of the phenomenological method of research. This method
utilizes interviews, observation and surveys to gather information
from subjects.
2.Ethnographic Model
• It immerses subjects in a culture that is unfamiliar to them. The
goal is to learn and describe the culture's characteristics much the
same way anthropologists observe the cultural challenges and
motivations that drive a group.
6/22/2021 18
19. 3.Grounded Theory Method
• This method tries to explain why a course of action evolved the way
it did. Theoretical models are developed based on existing data in
existing modes of genetic, biological or psychological science.
4.Case Study Model
• Unlike grounded theory, the case study model provides an in-depth
look at one test subject. The subject can be a person or family,
business or organization, or a town or city. Data is collected from
various sources and compiled using the details to create a bigger
conclusion.
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20. Qualitative data analysis
Most types of qualitative data analysis share the same five steps:
1. Prepare and organize data. This may mean transcribing interviews or typing up
fieldnotes.
2. Review and explore data. Examine the data for patterns or repeated ideas that
emerge.
3. Develop a data coding system. Based on initial ideas, establish a set of codes
that can be applied to categorize data.
4. Assign codes to the data. For example, in qualitative survey analysis, this may
mean going through each participant’s responses and tagging them with codes
in a spreadsheet. As you go through your data, you can create new codes to
add to your system if necessary.
5. Identify recurring themes. Link codes together into cohesive, overarching
themes.
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22. Advantages of qualitative method
• Flexibility
The data collection and analysis process can be adapted as new ideas or
patterns emerge. They are not rigidly decided beforehand.
• Natural settings
Data collection occurs in real-world contexts or in naturalistic ways.
• Meaningful insights
Detailed descriptions of people’s experiences, feelings and perceptions can
be used in designing, testing or improving systems or products.
• Generation of new ideas
Open-ended responses mean that researchers can uncover novel problems or
opportunities that they wouldn’t have thought of otherwise.
6/22/2021 22
23. Disadvantages of Qualitative methods
• Unreliability
The real-world setting often makes qualitative research unreliable
because of uncontrolled factors that affect the data.
• Subjectivity
Due to the researcher’s primary role in analyzing and interpreting
data, qualitative research cannot be replicated. The researcher
decides what is important and what is irrelevant in data analysis, so
interpretations of the same data can vary greatly.
• Limited generalizability
Small samples are often used to gather detailed data about specific
contexts. Despite rigorous analysis procedures, it is difficult to draw
generalised conclusions because the data may be biased and
unrepresentative of the wider population.
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24. Characteristics of qualitative research methods
1. Qualitative research methods usually collect data at the sight, where the
participants are experiencing issues or problems. These are real-time data
and rarely bring the participants out of the geographic locations to collect
information.
2. Qualitative researchers typically gather multiple forms of data, such as
interviews, observations, and documents, rather than rely on a single
data source.
3. This type of research method works towards solving complex issues by
breaking down into meaningful inferences, that is easily readable and
understood by all.
4. Since it’s a more communicative method, people can build their trust on
the researcher and the information thus obtained is raw and
unadulterated.
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26. About The Article
Journal : Infection control and hospital epidemiology
Received on: January 7, 2010
Accepted on : March 8, 2010
Electronically published : July 26, 2010
Authors :
Sanjay Saint, MD, MPH; Christine P. Kowalski, MPH; Jane Banaszak-Holl,
PhD; Jane Forman, ScD, MHS; Laura Damschroder, MS, MPH; Sarah L. Krein,
PhD, RN
26
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27. Reasons For Choosing This Article
• Topic of interest
• This articles is related to my field of study.
• As my thesis is based on the mixed method and the article is
based on similar method .
27
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28. INTRODUCTION
• Every year, approximately 100,000 people die of healthcare
associated infection (HAI) in American hospitals.
• The substantial economic costs of HAI will likely be increasingly
borne by hospitals, because the Centers for Medicare and
Medicaid Services no longer reimburses hospitals for the extra
cost of caring for patients who develop certain infections during
hospitalization.
28
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29. Introduction
.
• Although evidence-based recommendations are available to
prevent HAI, hospitals have implemented these recommended
practices to a highly variable extent.
• To determine which practices US hospitals are using to prevent
infection, they conducted a national, multicenter study that
entailed both quantitative and qualitative assessment.
29
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30. OBJECTIVE
• Healthcare-associated infections (HAIs) are costly and causes substantial
morbidity.
• The authors wanted to understand why some hospitals were engaged in HAI
prevention activities while others were not.
• Because preliminary data indicated that hospital leadership played an
important role, they sought better to understand which behaviors are
exhibited by leaders who are successful at implementing HAI prevention
practices in US hospitals.
30
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31. Materials and methods
• This article reports the second and third phases of a 3-phase sequential
mixed-methods project.
• During the first phase of the project, they conducted a quantitative survey to
discover what hospitals are doing to prevent HAI.
• They mailed this survey in March 2005 to the lead infection preventionist at
719 hospitals in the United States, including all Veterans Affairs (VA) medical
centers and a stratified random sample of non-VA general medical and
surgical hospitals.
• 516 of the hospitals sent responses i.e. 72% hospitals.
31
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32. Phase 2
• Study area: They used purposeful sampling to select 14
hospitals on the basis of their responses to the survey.
• Study period : Interviews were conducted during the period
from July 2005 through May 2006.
32
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33. Phase 3
• Study area: They identified 6 hospitals that would make up a
useful sample to elaborate themes that were emerging.
• Study period : From October 2006 through September 2007
33
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34. • Ethical approval : Institutional review boards of VA Ann Arbor
Healthcare System and of each hospital visited.
34
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35. Sample selection criteria
• They chose 14 hospitals in Phase 2 , on the basis of their responses
to the survey, used or did not use various practices to prevent HAI
and that varied across a number of other characteristics (eg,
number of beds or VA or academic status).
• For the third phase of the project, they identified 6 hospitals that
would make up a useful sample to elaborate themes that were
emerging. One such theme was the role of hospital leadership in
HAI prevention activities.
35
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36. Data Collection
• During phase 2, they conducted 2–4 semi-structured phone
interviews with participants at each of 14 hospitals, for a total of 38
interviews with a mean duration of 60 minutes.
• They were audio recorded and transcribed by a medical
transcriptionist.
• At least 2 team members conducted each interview. The first
interviewee at each hospital was an infection preventionist, who
was then asked to recommend other informants. Snowball sampling
was used for recruitment of interviwees.
36
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37. • They also interviewed staff whom the infection preventionist
did not mention but who they thought would provide valuable
information.
• Their interview guide included questions about practices that
the hospital used to prevent HAI, organizational characteristics,
and the involvement of leadership.
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38. • In phase 3, they conducted another 48 interviews during site
visits to 6 hospitals.
• The goal of the site visits was to fill in gaps and to test their
interpretations of issues identified in the phone interviews or
further explore these issues.
• They observed the hospitals’ environments and obtained
perspectives from additional staff, including senior executives,
mid-level managers, and front-line clinicians.
38
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39. Data Analysis
• Analyses were conducted with use of rigorous qualitative
procedures and included all of the phone and site visit interviews.
• Summaries were prepared after each interview, and the team met
at least monthly to identify and discuss emerging themes.
• Extensive summary reports, including one focused on leadership
were generated for each site by using all transcripts from phases 2
and 3.
• These summaries were prepared independently by 4 members of
the study team, and emerging themes were identified.
39
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44. Discussion
• Empirical data was collected from multiple sites that revealed
several key behaviors exhibited by hospital leaders who successfully
implemented HAI prevention practices.
• Notably, many of the most important leaders were not the senior
executives traditionally envisioned when the term “leader” is
mentioned.
•Instead, hospital epidemiologists, nurses, quality managers, and
infection preventionists played crucial leadership roles in their
hospital’s patient safety activities.
44
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45. Discussion
• Leadership styles can be broadly categorized as either transactional
or transformational.
• In general, transactional leaders guide their followers by ensuring
that roles and tasks are clearly specified and by using reward and
punishment as motivation.
• Transformational leaders may influence their followers by being
inspirational, providing a vision, and behaving in a manner that
serves as an example.
• In this study, transformational leadership was displayed by those
leaders who drove their staff to focus on a culture of clinical
excellence and by the hospital epidemiologist who was described
by his colleagues as inspiring. 45
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46. Discussion
• Several themes emerged from their qualitative analyses, including
general agreement that “vision,” “knowledge,” and “people skills”
were all characteristic of effective leaders.
• Similar to this findings about the importance of cultivating a culture of
clinical excellence, established leaders in their study also believed that
“organizational orientation”, dedication to the institution’s overall
success was a characteristic of effective leaders.
46
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47. Conclusion
They found that leadership broadly defined plays a key role in infection
prevention.
The qualitative assessment provides hospitals with suggestions of how
leaders can work to prevent HAI.
The difficult process of translating the findings of infection prevention
research into practice can be eased by leaders who heed the advice and
experiences of their colleagues who participated in this study.
47
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48. Limitations
• First, they did not seek a priority to discover the behaviors or styles
of successful leaders.
• Instead, midway through the study it became clear that leadership
played an important role; they then began further exploring the
behaviors that successful leaders exhibited.
• Second, the goal was not to generalize findings from a study sample
to a population but to provide information that could not be
gathered by means of a quantitative study.
48
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49. References
49
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1. Estimates of healthcare-associated infections. Centers for Disease Control and Prevention Web site.
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54. CASP tool
• The value of qualitative evidence synthesis for informing
healthcare policy and practice within evidence-based medicine
is increasingly recognised.
• The Critical Appraisal Skills Programme (CASP) tool is the most
commonly used tool for quality appraisal in health-related
qualitative evidence syntheses, with endorsement from the
Cochrane Qualitative and Implementation Methods Group.
Source: https://journals.sagepub.com/doi/full/10.1177/2632084320947559
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56. 1. Was there a clear statement of the aims of the
research?
• Yes
• There was a clear statement of the aims of the research.
Healthcare-associated infection (HAI) is costly and causes
substantial morbidity. The authors wanted to understand why
some hospitals were engaged in HAI prevention activities while
others were not. Because preliminary data indicated that hospital
leadership played an important role, they sought better to
understand which behaviors are exhibited by leaders who are
successful at implementing HAI prevention practices in US
hospitals. 56
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57. 2. Is a qualitative methodology appropriate?
• Yes.
• The authors use qualitative research to understand which behaviors
are exhibited by leaders who are successful at implementing HAI
prevention practices in US hospitals. As behavior is subjective and
not quantifiable. So, qualitative methodology is appropriate.
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58. 3. Was the research design appropriate to address the
aims of the research?
• Yes
• To determine which practices US hospitals are using to prevent
infection, the authors conducted a national, multicenter study that
entailed both quantitative and qualitative assessment.
• During the first phase of the project, they conducted a quantitative
survey at 719 hospitals in the United States and responses from 516
(72%) were received.
• On the basis of the survey data, they selected hospitals to participate in
the second and third phases of the study, during which they collected
and analyzed qualitative data to learn why hospitals are using certain
practices. 58
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59. 4. Was the recruitment strategy appropriate to the
aims of the research?
• Yes
• They chose 14 hospitals in Phase 2 , on the basis of their responses
to the survey, used or did not use various practices to prevent HAI
and that varied across a number of other characteristics (eg,
number of beds or VA or academic status).
• The first interviewee at each hospital was an infection
preventionist, who was then asked to recommend other
informants. Snowball sampling was used for recruitment of
interviwees. 59
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60. • For the third phase of the project, they identified 6 hospitals
that would make up a useful sample to elaborate themes that
were emerging. One such theme was the role of hospital
leadership in HAI prevention activities.
• They observed the hospitals’ environments and obtained
perspectives from additional staff, including senior executives,
mid-level managers, and front-line clinicians.
•
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61. 5. Was the data collected in a way that addressed the
research issue?
• Yes
• In phase 2, 14 purposefully sampled US hospitals were selected from among the
72% of 700 invited hospitals whose lead infection preventionist had completed a
quantitative survey on HAI prevention during phase 1.
• Qualitative data were collected during 38 semi-structured phone interviews with
key personnel at the 14 hospitals. During phase 3, they conducted 48 interviews
during 6 in-person site visits to identify recurrent themes that characterize
behaviors of successful leaders and to observe the hospitals’ environment. 61
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62. 6. . Has the relationship between researcher and
participants been adequately considered?
• No.
• The researcher has not mentioned about their own role, potential
bias and influence during
• (a) formulation of the research questions
• (b) data collection, including sample recruitment and choice of
location
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63. 7. Have ethical issues been taken into consideration?
• Yes
• Ethical clearance was obtained from Institutional review boards of
VA Ann Arbor Healthcare System and of each hospital visited.
• Anonymity of participants was also maintained.
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64. 8. Was the data analysis sufficiently rigorous?
• Yes
• Analyses were conducted with use of rigorous qualitative
procedures and included all of the phone and site visit interviews.
• Summaries were prepared after each interview, and the team met
at least monthly to identify and discuss emerging themes.
• Extensive summary reports, including one focused on leadership
were generated for each site by using all transcripts from phases 2
and 3.
• These summaries were prepared independently by 4 members of
the study team, and emerging themes were identified.
.
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65. 9. Is there a clear statement of findings?
• Yes
• Leadership plays an important role in infection prevention
activities. The behaviors of successful leaders could be adopted by
others who seek to prevent HAI.
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66. 10. How valuable is the result?
• The research is valuable.
• Every year, approximately 100,000 people die of healthcare associated infection
(HAI) in American hospitals. The substantial economic costs of HAI is very high.
• As the literature on the subject is replete with testaments to the importance of
leadership to an organization.
• Also, the role of leadership within a social sector, such as health care, is different
than that in a for-profit business and has received relatively little attention in the
peer-reviewed medical literature. 66
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