BMJ quality & safety
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BMJ quality & safety · Oct 2018
Ethical decision-making climate in the ICU: theoretical framework and validation of a self-assessment tool.
Literature depicts differences in ethical decision-making (EDM) between countries and intensive care units (ICU). ⋯ The 32-item version of the EDMCQ might enrich the EDM climate measurement, clinicians' behaviour and the performance of healthcare organisations. This instrument offers opportunities to develop tailored ICU team interventions.
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BMJ quality & safety · Oct 2018
Speak up-related climate and its association with healthcare workers' speaking up and withholding voice behaviours: a cross-sectional survey in Switzerland.
To determine frequencies of healthcare workers (HCWs) speak up-related behaviours and the association of speak up-related safety climate with speaking up and withholding voice. ⋯ Our results strengthen the importance of a speak up-supportive safety climate for staff safety-related communication behaviours, specifically withholding voice. This study indicates that a poor climate, in particular high levels of resignation among HCWs, is linked to frequent 'silence' of HCWs but not inversely associated with frequent speaking up. Interventions addressing safety-related voicing behaviours should discriminate between withholding voice and speaking up.
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BMJ quality & safety · Oct 2018
Perceptions of rounding checklists in the intensive care unit: a qualitative study.
Rounding checklists are an increasingly common quality improvement tool in the intensive care unit (ICU). However, effectiveness studies have shown conflicting results. We sought to understand ICU providers' perceptions of checklists, as well as barriers and facilitators to effective utilisation of checklists during daily rounds. ⋯ Our results provide potential insights about why ICU rounding checklists frequently fail to improve outcomes and offer a framework for effective checklist implementation through greater feedback and accountability.