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Serre N, Espin S, Indar A, Bookey-Bassett S, LeGrow K. Long-Term Care Nurses' Experiences With Patient Safety Incident Management: A Qualitative Study. J Nurs Care Qual 2022; 37:188-194. [PMID: 34261090 DOI: 10.1097/ncq.0000000000000583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Global trends in the aging population will increase the demands for long-term care (LTC) resources. Due to recent pressures to deliver more complex care, there is further risk to resident safety in LTC. Emphasis on the management and the delivery in safe and quality resident care in LTC is required. PURPOSE The purpose of this study was to describe nurses' experiences with patient safety incident (PSI) management involving residents living in LTC. METHODS Using a qualitative descriptive approach, 9 nurses were recruited in 3 LTC homes. Semistructured interviews were conducted, and data were analyzed using inductive content analysis. RESULTS Three main categories emerged: commitment to resident safety, workplace culture, and emotional reaction. CONCLUSIONS Providing nurses with an opportunity to share their PSI management experiences highlights the current factors influencing frontline resident safety in LTC. Study results can inform nursing practice and policy development to support PSI identification and management.
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Affiliation(s)
- Nicole Serre
- Medicine Department, Royal Victoria Regional Health Centre, Barrie, Canada (Ms Serre); Daphne Cockwell School of Nursing, Ryerson University, Toronto, Canada (Drs Espin, Bookey-Bassett, and LeGrow); and School of Health Sciences, Humber College, Toronto, Canada (Ms Indar)
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Choi EY, Pyo J, Lee W, Jang SG, Park YK, Ock M, Lee H. Perception Gaps of Disclosure of Patient Safety Incidents Between Nurses and the General Public in Korea. J Patient Saf 2021; 17:e971-e975. [PMID: 32910040 PMCID: PMC8612886 DOI: 10.1097/pts.0000000000000781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES This study aimed to explore nurses' perceptions regarding disclosure of patient safety incidents. METHODS An anonymous online survey was conducted, and results were compared with those of the general public using the same questionnaire in a previous study. RESULTS Among 689 nurses, 96.8% of nurses felt major errors should be disclosed to patients or their caregivers, but only 67.5% felt disclosure of medical errors should be mandatory. In addition, 58.5% of nurses were concerned that disclose will increase the incidence of medical lawsuits. More than two-thirds of nurses felt such discloses will reduce feelings of guilt associated with a patient safety incident. Only 51.1% of nurses, but 93.3% of the public, felt near misses should be disclosed to patients. CONCLUSIONS Nurses generally had a positive attitude toward disclosure of patient safety incidents, but they preferred it less than the general public. To reduce this gap, legal and nonlegal measures will need to be implemented. Furthermore, it is necessary to continue monitoring the gap by regularly assessing perceptions of disclosure of patient safety incidents among health care professionals and the general public.
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Affiliation(s)
- Eun Young Choi
- From the Department of Nursing, Graduate School of Chung-Ang University, Seoul
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - Jeehee Pyo
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
- Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine
| | - Won Lee
- Red Cross College of Nursing, Chung-Ang University
| | | | - Young-Kwon Park
- Prevention and Care Center, Ulsan University Hospital, Ulsan
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
- Prevention and Care Center, Ulsan University Hospital, Ulsan
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Haeyoung Lee
- Red Cross College of Nursing, Chung-Ang University
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Yeung JWY. Adverse Event Disclosure Training for Nursing Students: Peer Role-Play and Simulated Patients. Int J Nurs Educ Scholarsh 2019; 16:ijnes-2019-0094. [PMID: 31863696 DOI: 10.1515/ijnes-2019-0094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/30/2019] [Indexed: 11/15/2022]
Abstract
Background Simulation has proven valuable in nursing communication training, but there are limited studies comparing the effectiveness of different training methods, especially in the area of adverse event disclosure (AED) training. Therefore, this study aimed to examine the impact of two training methods, peer role-play (PRP) and simulated patients (SP) on the self-efficacy and performance of nursing students in AED in a simulated environment. Methods Forty-four nursing students participated. Students' self-efficacy toward AED was assessed using the pre/post-test method. Also, students' performance was evaluated after the simulation encounter. Results It showed a significant difference in self-efficacy between the groups. However, no significant difference emerged between the groups in performance. Conclusion This study provides a basis for comparison of these two methods in patient communication training. Educators should consider their resources and expected learning outcomes in designing the emotionally draining adverse event disclosure training.
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Affiliation(s)
- Joanna Wing Yan Yeung
- Department of Health and Nursing Sciences, School of Nursing, Tung Wah College, Kowloon, Hong Kong
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Choi EY, Pyo J, Ock M, Lee SI. Nurses' Perceptions Regarding Disclosure of Patient Safety Incidents in Korea: A Qualitative Study. Asian Nurs Res (Korean Soc Nurs Sci) 2019; 13:200-208. [DOI: 10.1016/j.anr.2019.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 05/26/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022] Open
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Wagner LM, Driscoll L, Darlington JL, Flores V, Kim J, Melino K, Patel HD, Spetz J. Nurses' Communication of Safety Events to Nursing Home Residents and Families. J Gerontol Nurs 2018; 44:25-32. [PMID: 28990635 DOI: 10.3928/00989134-20171002-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 08/14/2017] [Indexed: 11/20/2022]
Abstract
Although communication is an essential part of the nursing process, nurses have little to no formal education in how to best communicate patient safety event (PSE) information to nursing home (NH) residents and their family members. The current mixed-methods study tested an intervention aimed at educating nurses on how to communicate a PSE to residents/family members using a structured communication tool. Nurse participants improved their knowledge of PSE communication, especially about the cause of the event, what they would say to the resident/family member, and future prevention of the PSE. Through qualitative subgroup analysis, an increased number of empathic statements were noted post-intervention. The tool tested in this study provides structure to an important care process that is necessary for improving the culture of safety in NH settings. [Journal of Gerontological Nursing, 44(2), 25-32.].
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Wagner LM, Dolansky MA, Englander R. Entrustable professional activities for quality and patient safety. Nurs Outlook 2017; 66:237-243. [PMID: 29544650 DOI: 10.1016/j.outlook.2017.11.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/14/2017] [Accepted: 11/15/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Further efforts are warranted to identify innovative approaches to best implement competencies in nursing education. To bridge the gap between competency-based education, practice, and implementation of knowledge, skills, and attitudes, one emerging approach is entrustable professional activities (EPAs). PURPOSE The objective of this study was to introduce the concept of EPAs as a framework for curriculum and assessment in graduate nursing education and training. METHODS Seven steps are provided to develop EPAs for nurses through the example of a quality and safety EPA. The example incorporates the Quality and Safety Education for Nurses (QSEN) patient safety competencies and evidence-based literature. FINDINGS EPAs provide a practical approach to integrating competencies in nursing as quality and safety are the cornerstones of nursing practice, education, and research. DISCUSSION Introducing the EPA concept in nursing is timely as we look to identify opportunities to enhance nurse practitioner (NP) training models and implement nurse residency programs.
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Affiliation(s)
- Laura M Wagner
- University of California, San Francisco, School of Nursing, San Francisco, CA.
| | - Mary A Dolansky
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
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Gartshore E, Waring J, Timmons S. Patient safety culture in care homes for older people: a scoping review. BMC Health Serv Res 2017; 17:752. [PMID: 29157257 PMCID: PMC5697159 DOI: 10.1186/s12913-017-2713-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 11/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes. METHODS A scoping review was undertaken to describe the availability of evidence related to care homes' patient safety culture, what these studies focused on, and identify any knowledge gaps within the existing literature. Included papers were each reviewed by two authors for eligibility and to draw out information relevant to the scoping review. RESULTS Twenty-four empirical papers and one literature review were included within the scoping review. The collective evidence demonstrated that safety culture research is largely based in the USA, within Nursing Homes rather than Residential Home settings. Moreover, the scoping review revealed that empirical evidence has predominantly used quantitative measures, and therefore the deeper levels of culture have not been captured in the evidence base. CONCLUSIONS Safety culture in care homes is a topic that has not been extensively researched. The review highlights a number of key gaps in the evidence base, which future research into safety culture in care home should attempt to address.
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Affiliation(s)
- Emily Gartshore
- Centre for Health Innovation Leadership and Learning, Nottingham Business School, Jubilee Campus, Nottingham, NG8 1BB UK
| | - Justin Waring
- Centre for Health Innovation Leadership and Learning, Nottingham Business School, Jubilee Campus, Nottingham, NG8 1BB UK
| | - Stephen Timmons
- Centre for Health Innovation Leadership and Learning, Nottingham Business School, Jubilee Campus, Nottingham, NG8 1BB UK
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Ock M, Lim SY, Jo MW, Lee SI. Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review. J Prev Med Public Health 2017; 50:68-82. [PMID: 28372351 PMCID: PMC5398338 DOI: 10.3961/jpmph.16.105] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/17/2017] [Indexed: 11/30/2022] Open
Abstract
Objectives We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI). Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them. Results There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI. Conclusions The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required.
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Affiliation(s)
- Minsu Ock
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - So Yun Lim
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Il Lee
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
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Prothero MM, Morse JM. Eliciting the Functional Processes of Apologizing for Errors in Health Care: Developing an Explanatory Model of Apology. Glob Qual Nurs Res 2017; 4:2333393617696686. [PMID: 28540337 PMCID: PMC5433672 DOI: 10.1177/2333393617696686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 11/15/2022] Open
Abstract
The purpose of this article was to analyze the concept development of apology in the context of errors in health care, the administrative response, policy and format/process of the subsequent apology. Using pragmatic utility and a systematic review of the literature, 29 articles and one book provided attributes involved in apologizing. Analytic questions were developed to guide the data synthesis and types of apologies used in different circumstances identified. The antecedents of apologizing, and the attributes and outcomes were identified. A model was constructed illustrating the components of a complete apology, other types of apologies, and ramifications/outcomes of each. Clinical implications of developing formal policies for correcting medical errors through apologies are recommended. Defining the essential elements of apology is the first step in establishing a just culture in health care. Respect for patient-centered care reduces the retaliate consequences following an error, and may even restore the physician patient relationship.
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