Patient and public involvement in the design and protocol development for a platform randomised trial to evaluate diagnostic tests to optimise antimicrobial therapy (PROTECT).

Background: Our patient and public involvement activities were part of a project aiming to develop a master protocol and National Institute for Health and Care research application for the PROTECT trial aiming to assess the effectiveness, implementation, and efficiency of antimicrobial stewardship interventions, to safely reduce unnecessary antibiotic usage by excluding severe bacterial infection in acutely unwell patients.

Methods: Three public involvement sessions were held with representation from young people and parents, people from diverse backgrounds and people with experience of presenting to the emergency department with undifferentiated illness. The teleconference meetings lasted between 60-90 minutes, were recorded, notes were subsequently taken, and findings summarised.

Driving resumption after critical illness:A survey and framework analysis of patient experience and process.

Adverse sequelae are common in survivors of critical illness. Physical, psychological and cognitive impairments can affect quality of life for years after the original insult. Driving is an advanced task reliant on complex physical and cognitive functioning.

How do frontline staff use patient experience data for service improvement? Findings from an ethnographic case study evaluation.

Objectives: Improving patient experience is widely regarded as a key component of health care quality. However, while a considerable amount of data are collected about patient experience, there are concerns this information is not always used to improve care. This study explored whether and how frontline staff use patient experience data for service improvement.

The contribution of ethnography to the evaluation of quality improvement in hospital settings: reflections on observing co-design in intensive care units and lung cancer pathways in the UK.

Ethnography is increasingly being used in the evaluation of quality improvement and change initiatives in healthcare settings, particularly in the form of 'focused' and 'rapid' ethnographies. This new ethnographic genre is tailored to suit narrower enquiries within clinical pathways. However, the application of ethnography to the evaluation of quality improvement is not straightforward or free from reductionist bias, particularly in hospital settings where interventions take place during a limited period of time and instigate change in busy and sensitive settings.

What patients do and their impact on implementation.

Purpose: The potential for including patients in implementation processes has received limited attention in the literature. The purpose of this paper is to explore the different roles adopted by 63 patients that emerged during and after four participatory quality improvement interventions, and the nature of their impact upon implementation processes and outcomes.

Design/methodology/approach: A cross-case ethnographic comparison of Experience-based Co-design in two clinical pathways in two UK NHS Trusts.

Using a national archive of patient experience narratives to promote local patient-centered quality improvement: an ethnographic process evaluation of 'accelerated' experience-based co-design.

Objectives: To evaluate an accelerated form of experience-based co-design (EBCD), a type of participatory action research in which patients and staff work together to improve quality; to observe how acceleration affected the process and outcomes of the intervention.

Methods: An ethnographic process evaluation of an adapted form of EBCD was conducted, including observations, interviews, questionnaires and documentary analysis. Whilst retaining all components of EBCD, the adapted approach replaced local patient interviews with secondary analysis of a national archive of patient experience narratives to create national trigger films; shortened the timeframe; and employed local improvement facilitators.

New measures to improve patients' experiences of care.

This article outlines a new guidance and quality standard for patient experience. It focuses on the generic patient experience and is aimed at all clinical and non-clinical staff providing services for adults in NHS settings. The guidance focuses on improving the patient experience and has been developed by the National Clinical Guideline Centre as part of a National Institute for Health and Clinical Excellence-commissioned portfolio of work.

Call 4 Concern: patient and relative activated critical care outreach.

Patients can experience unexpected deterioration in their physiological condition that can lead to critical illness, cardiac arrest, admission to the intensive care unit and death. While ward staff can identify deterioration through monitoring physiological signs, these signs can be missed, interpreted incorrectly or mismanaged. Rapid response systems using early warning scores can fail if staff do not follow protocols or do not notice or manage deterioration adequately.

A self-report-based study of the incidence and associations of sexual dysfunction in survivors of intensive care treatment.

Objectives: To determine the incidence and associations of sexual dysfunction in survivors of intensive care unit treatment in their first year after hospital discharge using a self-report measure.

Design: A prospective observational study.

Setting: ICU Follow-up Clinic, The Royal Berkshire Hospital, Reading.

British Association of Critical Care Nurses position statement on the use of restraint in adult critical care units.

Critical care nurses in the United Kingdom have become increasingly concerned about the use, potential abuse and risks associated with physical restraint of patients. Restraint in critical care is not only confined to physical restraint but can also encompass chemical and psychological methods. There are concerns regarding the legal and ethical issues relating to the (ab)use of physical restraint techniques in critical care.

Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care.

Objective: To evaluate the effectiveness of the provision of information in the form of a rehabilitation program following critical illness in reducing psychological distress in the patients' close family.

Design: Randomised controlled trial, blind at follow-up with final assessment at 6 months.

Setting: Two district general hospitals and one teaching hospital.

Rehabilitation after critical illness: a randomized, controlled trial.

Objective: To evaluate the effectiveness of a rehabilitation program following critical illness to aid physical and psychological recovery.

Design: Randomized controlled trial, blind at follow-up with final assessment at 6 months.

Setting: Two district general hospitals and one teaching hospital.