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Starting at the top: culture change has the potential to advance the patient participation agenda in Iranian hospitals

Por: Tobiano · G. · Chaboyer · W.

Commentary on: Sarkhosh S, Abdi Z, Ravaghi H. Engaging patients in patient safety: a qualitative study examining healthcare managers and providers' perspectives. BMC Nurs. 2022 Dec 29;211,:374. doi: 10.1186/s12912-022-01152-1.

Implications for practice and research

  • Without a shift in organisational culture, patient participation in patient safety may continue to be haphazard in Iranian hospitals.

  • Researchers should consider and report the impact of gender when investigating patient participation in care.

  • Context

    Despite Iran’s economic crisis, brought on by sanctions, years of war and improper government resource management, Iranian healthcare is now considered among the finest in the Eastern Mediterranean region.1 There are satisfactory secondary and tertiary hospitals, and progress towards eradication of contagious, maternal and neonatal disorders has been made.1 Internationally, patient participation in hospital safety activities is advocated, such as patients detecting and reporting symptoms, side effects and hospital issues, to...

    Post‐operative nursing activities to prevent wound complications in patients undergoing colorectal surgeries: A scoping review

    Abstract

    Aims

    To identify postoperative interventions and quality improvement initiatives used to prevent wound complications in patients undergoing colorectal surgeries, the types of activities nurses undertake in these interventions/initiatives and how these activities align with nurses' scope of practice.

    Design

    A scoping review.

    Data Sources

    Three health databases were searched, and backward and forward citation searching occurred in April 2022. Research and quality improvement initiatives included focussed on adult patients undergoing colorectal surgery, from 2010 onwards. Data were extracted about study characteristics, nursing activities and outcomes. The ‘Dimensions of the scope of nursing practice’ framework was used to classify nursing activities and then the Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework was used to synthesise the review findings.

    Results

    Thirty-seven studies were included. These studies often reported negative wound pressure therapy and surgical site infection bundle interventions/initiatives. Nurses' scope of practice was most frequently ‘Technical procedure and delegated medical care’ meaning nurses frequently acted under doctors' orders, with the most common delegated activity being dressing removal.

    Conclusion

    The full extent of possible interventions nurses could undertake independently in the postoperative period requires further exploration to improve wound outcomes and capitalise on nurses' professional role.

    Impact Statement

    Nurses' role in preventing postoperative wound complications is unclear, which may inhibit their ability to influence postoperative outcomes. In the postoperative period, nurses undertake technical activities, under doctors' orders to prevent wound infections. For practice, nurses need to upkeep and audit their technical skills. New avenues for researchers include exploration of independent activities for postoperative nurses and the outcomes of these activities.

    Implications for the Profession and/or Patient Care

    There may be opportunities to broaden nurses' scope of practice to act more autonomously to prevent wound complication.

    Reporting Method

    Scoping Reviews (PRISMA-ScR) checklist.

    Patient or Public Contribution

    A health consumer interpreted the data and prepared the manuscript.

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