Quantity and quality of interaction between staff and older patients in UK hospital wards: A descriptive study.
Hannah Ruth Barker, Peter Griffiths, Ines Mesa-Eguiagaray and 3 others
PMID 27472441WHAT IT FOUND
On older-person acute wards, 60% of staff-patient interactions were positive care and 13% positive social, but 10% were negative and 40% of patients with two hours of observation had at least one negative interaction.
Negative interactions were associated with patient-initiated, one-way, and multi-staff encounters.
Key findings
01There was a mean of six interactions per patient per hour, and the mean interaction length was 101 seconds with a median of 36 seconds.
02Sixty percent of interactions were positive care and 13% were positive social.
03Ten percent of interactions were negative, 6% were negative restrictive, and 40% of patients with two hours of observation had at least one negative interaction.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only six wards in two hospitals were studied, so ward culture, staffing, and patient mix may not apply elsewhere. Patients identified as palliative, critically ill, or reverse barrier nursed were excluded, so the findings do not describe those groups. Observations were only two hours per session, and the study did not show whether necessary care was omitted or whether interaction content was appropriate. The Quality of Interactions Schedule was adapted from long-term settings for acute wards, and further validation against patient experience is needed. Staffing levels and skill mix were not significantly associated with negative interactions, so this study does not settle workload questions. The associations are not causal; patient-initiated, one-way, multi-staff, communication, and personal care factors may mark harder encounters rather than cause negative interactions. The multi-level model showed more variation at ward and session levels than at patient level, so findings may reflect local context.
The easy way to misread this
Do not conclude that this study proves that changing patient-initiated, one-way, or multi-staff interactions will reduce negative interactions. It is descriptive baseline observation from a feasibility study, and the associations do not show cause.