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Shemsu A, Dechasa A, Ayana M, Tura MR. Patient safety incident reporting behavior and its associated factors among healthcare professionals in Hadiya zone, Ethiopia: A facility based cross-sectional study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 6:100209. [PMID: 38952573 PMCID: PMC11214984 DOI: 10.1016/j.ijnsa.2024.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/11/2024] [Accepted: 05/21/2024] [Indexed: 07/03/2024] Open
Abstract
Background Incidents affecting patient safety can cause unnecessary injury to a patient. It is generally accepted that incident reporting can improve patient safety. In Ethiopian public hospitals, especially in the Hadiya zone, patient safety-related incidents are commonly witnessed, but there is no evidence of reporting behavior among healthcare professionals. Purpose This study aimed to assess patient safety incident reporting behavior and its associated factors among healthcare professionals working in public hospitals in the Hadiya zone, South Nation's, Nationalities, and Peoples' Region, Ethiopia, in 2021. Method A cross-sectional study design was employed, among 345 healthcare professionals working in public hospitals in the Hadiya zone from August 1-30, 2021. A simple random sampling technique was used to select study participants, and a structured self-administered questionnaire which is adapted from a Hospital survey on patient safety survey and literature was used to collect the data. The data were entered into a data attraction template prepared using the Epi data software and then exported to the SPSS version 25 software for analysis. Descriptive analyses were conducted to determine the general characteristics and distributions of the data collected. An inferential statistical analysis was conducted using the logistic regression model to identify associations between outcome and predictor variables. The odds ratio with the 95 % confidence interval was used to test the associations between the outcome variable and predictor variables. Finally, statistical significance was set at p-value < 0.05. Results From the total of 354 healthcare professionals expected, 334 participants, which gave a response rate of 94.4 %, had completed and returned the questionnaire. The result shows that overall patient safety incident reporting behavior among healthcare professionals was 28.7 % (95 % Confidence Interval (CI): (24.6, 33.2). Being a nurse professional [Adjusted Odd Ratio (AOR): 5.48, 95 % CI: (1.67, 17.80)], having job training [AOR: 2.87, 95 % CI: (1.46, 6.28)], having a team within the units [AOR=2.79, 95 %CI: (1.23, 6.28)], communication openness [AOR=2.78, 95 %CI: (1.44, 5.37)], and management support [AOR=2.8, 95 %CI; (1.40, 5.60)] were found to factor significantly associated with patient safety incident reporting behaviour. Conclusion This study revealed that the incident-reporting behavior among healthcare professionals was low compared to previous studies. Being a nurse professional, having an on -job training, having a team within the unit, communication openness, perception of the time reporting takes, fear of administration sanction and management support were factors associated with their patient safety incident reporting behavior. Managers should focus on patient safety incidents, prepare continuous training programs, and provide open communication to improve patient safety incident reporting.
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Affiliation(s)
- Amina Shemsu
- Department of Nursing, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Abebe Dechasa
- Department of Nursing, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Mulatu Ayana
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Meseret Robi Tura
- Department of Nursing, College of Medicine and Health Sciences, Ambo University, Ethiopia
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Gqaleni TMH, Mkhize SW. Barriers to implementing patient safety incident reporting and learning guidelines in specialised care units, KwaZulu-Natal: A qualitative study. PLoS One 2024; 19:e0289857. [PMID: 38457469 PMCID: PMC10923419 DOI: 10.1371/journal.pone.0289857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/06/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Globally, increased occurrences of patient safety incidents have become a public concern. The implementation of Patient safety incidents reporting and learning guidelines is fundamental to reducing preventable patient harm. To improve the implementation of these guidelines in specialised care units in KwaZulu-Natal, the views of healthcare professionals were unearthed. AIM This study explores the healthcare professionals' views toward the implementation of Patient safety incident reporting and learning guidelines in specialised care units. METHODS A descriptive, explorative qualitative approach was used to collect qualitative data from healthcare professionals working in specialised care units. The study was conducted in specialised care units of three purposely selected public hospitals in two districts of KwaZulu-Natal. Group discussions and semi-structured interviews were conducted from August to October 2021. Content data analysis was performed using Tesch's method of analysis process. RESULTS The main themes that emerged during data analysis were; ineffective reporting system affecting the communication of Patient safety incident guidelines, inadequate institutional and management support for the healthcare professionals, insufficient education and training of healthcare professionals, and poor human resources affecting the implementation of Patient Safety Incident guidelines. The findings highlighted that there were more major barriers to the implementation of the Patient safety incident reporting and learning guidelines. CONCLUSION This study confirmed that the Patient safety incident reporting and learning guidelines are still not successfully implemented in the specialised care units and the barriers to implementation were highlighted. For rigorous implementation in South Africa, the study recommends revised Patient safety incident reporting and learning guidelines, designed in consultation with the frontline healthcare professionals. These must consist of standardised, simple- user-friendly reporting process as well as a better implementation strategy to guide the healthcare professionals. Continuous professional development programmes may play an important role in the facilitation of the implementation process.
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Affiliation(s)
- T. M. H. Gqaleni
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Sipho W. Mkhize
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Ko YK, Cho C, Sun S, Ngan OM, Chan HY. Moral sensitivity and academic ethical awareness of nursing and medical students: A cross-sectional survey. Nurs Ethics 2024:9697330241226604. [PMID: 38315791 DOI: 10.1177/09697330241226604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND Moral sensitivity and academic integrity discernment hold paramount importance for healthcare professionals. Owing to distinct undergraduate educational backgrounds, nurses and physicians may exhibit divergent moral perspectives, academic integrity cognisance, and moral sensitivity within clinical environments. A limited number of studies have investigated the disparities and congruencies pertaining to moral sensitivity and academic ethical awareness among nursing and medical students. OBJECTIVE The study compares moral sensitivity and academic ethical awareness of undergraduate nursing and medical students with and without clinical exposure. RESEARCH DESIGN A self-administered cross-sectional survey conducted from January to February 2022 was used to collect data from a medical school in Hong Kong. PARTICIPANTS AND RESEARCH CONTEXT A total of 545 respondents, including 137 nursing students and 408 medical students, completed the questionnaire. ETHICAL CONSIDERATION Ethics approval of the study was obtained. Written consent was waived to maintain anonymity because completing the questionnaire was considered implied consent. FINDINGS Both groups of undergraduates demonstrated a high level of bioethics knowledge. In terms of academic integrity, medical students were found to have a less concerned attitude towards punctuality, attendance, and skipping classes. Regarding moral sensitivity, senior medical students with clinical experience put less emphasis on decision-making involving patient participation, while senior nursing students were more hesitant in withholding treatment for incompetent patients who refused treatment. Both nursing and medical students showed decreased moral sensitivity in the 'conflicts' domain with increased clinical exposure. CONCLUSION Study findings contribute to the discussion comparing the ethical attitudes of nursing and medical students. More effort should be made in nursing and medical education to promote practices in line with high academic integrity and to develop the ability to be morally sensitive in professional settings.
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Affiliation(s)
- Yuet Kiu Ko
- Faculty of Medicine, The Chinese University of Hong Kong
| | - Cordelia Cho
- Faculty of Medicine, The Chinese University of Hong Kong
| | - Sihan Sun
- CUHK Centre of Bioethics, Faculty of Medicine, The Chinese University of Hong Kong
| | - Olivia My Ngan
- Medical Ethics and Humanities Unit and Centre for Centre for Medical Ethics and Law, The University of Hong Kong
| | - Helen Yl Chan
- School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
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4
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Munn LT, Lynn MR, Knafl GJ, Willis TS, Jones CB. A study of error reporting by nurses: the significant impact of nursing team dynamics. J Res Nurs 2023; 28:354-364. [PMID: 37885949 PMCID: PMC10599306 DOI: 10.1177/17449871231194180] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
Background Error reporting is crucial for organisational learning and improving patient safety in hospitals, yet errors are significantly underreported. Aims The aim of this study was to understand how the nursing team dynamics of leader inclusiveness, safety climate and psychological safety affected the willingness of hospital nurses to report errors. Methods The study was a cross-sectional design. Self-administered surveys were used to collect data from nurses and nurse managers. Data were analysed using linear mixed models. Bootstrap confidence intervals with bias correction were used for mediation analysis. Results Leader inclusiveness, safety climate and psychological safety significantly affected willingness to report errors. Psychological safety mediated the relationship between safety climate and error reporting as well as the relationship between leader inclusiveness and error reporting. Conclusion The findings of the study emphasise the importance of nursing team dynamics to error reporting and suggest that psychological safety is especially important to error reporting.
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Affiliation(s)
- Lindsay Thompson Munn
- Co-Director of Workforce Development, Clinical and Translational Science Institute, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Mary R Lynn
- Professor, University of North Carolina, Chapel Hill, NC, USA
| | - George J Knafl
- Emeritus Professor, School of Nursing, University of North Carolina, Chapel Hill, NC, USA
| | - Tina Schade Willis
- Professor of Clinical Pediatrics, Division of Pediatric Critical Care, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Cheryl B Jones
- Professor and Director, Hillman Scholar Program in Nursing Innovation, School of Nursing, University of North Carolina, Chapel Hill, NC, USA
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Kurihara M, Watari T, Rohde JM, Gupta A, Tokuda Y, Nagao Y. Nationwide survey on Japanese residents' experience with and barriers to incident reporting. PLoS One 2022; 17:e0278615. [PMID: 36455042 PMCID: PMC9714900 DOI: 10.1371/journal.pone.0278615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/18/2022] [Indexed: 12/04/2022] Open
Abstract
The ability of any incident reporting system to improve patient care is dependent upon robust reporting practices. However, under-reporting is still a problem worldwide. We aimed to reveal the barriers experienced while reporting an incident through a nationwide survey in Japan. We conducted a cross-sectional survey. All first- and second-year residents who took the General Medicine In-Training Examination (GM-ITE) from February to March 2021 in Japan were selected for the study. The voluntary questionnaire asked participants regarding the number of safety incidents encountered and reported within the previous year and the barriers to reporting incidents. Demographics were obtained from the GM-ITE. The answers of respondents who indicated they had never previously reported an incident (non-reporting group) were compared to those of respondents who had reported at least one incident in the previous year (reporting group). Of 5810 respondents, the vast majority indicated they had encountered at least one safety incident in the past year (n = 4449, 76.5%). However, only 2724 (46.9%) had submitted an incident report. Under-reporting (more safety incidents compared to the number of reports) was evident in 1523 (26.2%) respondents. The most frequently mentioned barrier to reporting an incident was the time required to file the report (n = 2622, 45.1%). The barriers to incident reporting were significantly different between resident physicians who had previously reported and those who had never previously reported an incident. Our study revealed that resident physicians in Japan commonly encounter patient safety incidents but under-report them. Numerous perceived and experienced barriers to reporting remain, which should be addressed if incident reporting systems are to have an optimal impact on improving patient safety. Incident reporting is essential for improving patient safety in an institution, and this study recommends establishing appropriate interventions according to each learner's barriers for reporting.
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Affiliation(s)
- Masaru Kurihara
- Department of Patient Safety, Nagoya University Hospital, Nagoya, Japan
| | - Takashi Watari
- General Medicine Center, Shimane University Hospital, Izumo, Shimane, Japan
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America
- Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- * E-mail:
| | - Jeffrey M. Rohde
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America
- Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Ashwin Gupta
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America
- Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | | | - Yoshimasa Nagao
- Department of Patient Safety, Nagoya University Hospital, Nagoya, Japan
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6
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Zhao X, Shi C, Zhao L. Nurses' Intentions, Awareness and Barriers in Reporting Adverse Events: A Cross-Sectional Survey in Tertiary Hospitals in China. Risk Manag Healthc Policy 2022; 15:1987-1997. [PMID: 36329826 PMCID: PMC9624208 DOI: 10.2147/rmhp.s386458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/20/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose This study explored nurses’ intentions, awareness and barriers in reporting adverse events in tertiary hospitals in China. We also analyzed its associated factors to increase the chance to evaluate preventable errors, enhance care delivery, and improve patient outcomes. Patients and Methods A cluster sampling method was used to recruit 1382 nurses from two tertiary hospitals in Chenzhou and Handan City. An online structured questionnaire was used to collect data, which included general information questionnaire (eight questions), reporting awareness questionnaire (eight items with scores ranging from 0 to 8), reporting intention questionnaire (15 items with scores ranging from 0 to 15), and reporting barriers questionnaire (22 items with scores ranging from 22 to 110). Results We received 1565 completed questionnaires from 1734 potential participants (a response rate of 90.25%), with 1382 valid questionnaires, yielding an effective rate of 88.31%. The scores of reporting awareness, reporting intention, and reporting barriers in adverse events for nurses in tertiary hospitals were 8 (1), 15 (0), and 83.04 (±12.21) out of 110, respectively. Reporting awareness and barriers to adverse events were positively correlated with nurses’ intention to report adverse events (rs = 0.237 and 0.361, respectively; P < 0.001). Regression analyses showed that reporting awareness and barriers in adverse events and professional title influenced nurses’ intention to report adverse events (P < 0.05) in tertiary hospitals. Conclusion Nurses in tertiary hospitals have a strong intention to report adverse events. The higher the reporting awareness of adverse events or the fewer perceived reporting barriers, the stronger the nurses’ intention to report. Hospital managers should deliver patient safety education and training for nurses, to increase their reporting awareness and decrease their perceived reporting barriers, improve their intention to report adverse events.
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Affiliation(s)
- Xiaoying Zhao
- Handan First Hospital, Handan, 056000, People’s Republic of China
| | - Chunhong Shi
- School of Nursing, Xiangnan University, Chenzhou, People’s Republic of China,Affiliated Hospital of Xiangnan University, Chenzhou, 423000, People’s Republic of China,Correspondence: Chunhong Shi, School of Nursing, Xiangnan University, 889 Chenzhou Avenue, Suxian District, Chenzhou, 423000, People’s Republic of China, Tel +86 15907354840, Fax +86-735-2325007, Email
| | - Lihua Zhao
- Handan First Hospital, Handan, 056000, People’s Republic of China
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Yeung AWK, Kletecka-Pulker M, Klager E, Eibensteiner F, Doppler K, El-Kerdi A, Willschke H, Völkl-Kernstock S, Atanasov AG. Patient Safety and Legal Regulations: A Total-Scale Analysis of the Scientific Literature. J Patient Saf 2022; 18:e1116-e1123. [PMID: 35617635 DOI: 10.1097/pts.0000000000001040] [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
OBJECTIVE The aim of the study was to quantitatively analyze the scientific literature landscape covering legal regulations of patient safety. METHODS This retrospective bibliometric analysis queried Web of Science database to identify relevant publications. The identified scientific literature was quantitatively evaluated to reveal prevailing study themes, contributing journals, countries, institutions, and authors, as well as citation patterns. RESULTS The identified 1295 publications had a mean of 13.8 citations per publication and an h-index of 57. Approximately 78.8% of them were published since 2010, with the United States being the top contributor and having the greatest publication growth. A total of 79.2% (n = 1025) of the publications were original articles, and 12.5% (n = 162) were reviews. The top authors (by number of publications published on the topic) were based in the United States and Spain and formed 3 collaboration clusters. The top institutions by number of published articles were mainly based in the United States and United Kingdom, with Harvard University being on top. Internal medicine, surgery, and nursing were the most recurring clinical disciplines. Among 4 distinct approaches to improve patient safety, reforms of the liability system (n = 91) were most frequently covered, followed by new forms of regulation (n = 73), increasing transparency (n = 67), and financial incentives (n = 38). CONCLUSIONS Approximately 78.8% of the publications on patient safety and its legal implications were published since 2010, and the United States was the top contributor. Approximately 79.2% of the publications were original articles, whereas 12.5% were reviews. Healthcare sciences services was the most recurring journal category, with internal medicine, surgery, and nursing being the most recurring clinical disciplines. Key relevant laws around the globe were identified from the literature set, with some examples highlighted from the United States, Germany, Italy, France, Sweden, Poland, and Indonesia. Our findings highlight the evolving nature and the diversity of legislative regulations at international scale and underline the importance of healthcare workers to be aware of the development and latest advancement in this field and to understand that different requirements are established in different jurisdictions so as to safeguard the necessary standards of patient safety.
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Affiliation(s)
| | | | - Elisabeth Klager
- From the Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBIDHPS), Medical University of Vienna, Vienna, Austria
| | | | - Klara Doppler
- From the Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBIDHPS), Medical University of Vienna, Vienna, Austria
| | - Amer El-Kerdi
- From the Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBIDHPS), Medical University of Vienna, Vienna, Austria
| | | | - Sabine Völkl-Kernstock
- From the Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBIDHPS), Medical University of Vienna, Vienna, Austria
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Crunden EA, Worsley PR, Coleman SB, Schoonhoven L. Barriers and facilitators to reporting medical device-related pressure ulcers: A qualitative exploration of international practice. Int J Nurs Stud 2022; 135:104326. [DOI: 10.1016/j.ijnurstu.2022.104326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/13/2022] [Accepted: 07/11/2022] [Indexed: 10/31/2022]
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Cook-Richardson S, Addo A, Kim P, Turcotte J, Park A. Show Me the Money, I'll Show You My Complications: Impacts of Incentivized Incident Self-Reporting Among Surgeons. J Surg Res 2022; 274:136-144. [PMID: 35150946 DOI: 10.1016/j.jss.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/29/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Trial and error have the propensity to generate knowledge. Near misses and adverse event reporting can improve patient care. Professional ridicule or litigation risks after an incident may lead to decreased reporting by physicians; however, the lack of incident reporting can negatively affect patient safety and halt scientific advancements. This study compares reporting patterns after distribution of financial incentives to surgeons for self-reporting quality incidents. METHODS Retrospective review of an internal incident reporting system, RL6, from September 2018 to September 2019 was performed. Incident reporting patterns after incentive distributions across professional classifications and surgical specialties were evaluated. Engagement surveys on incident reporting were completed by physicians. The primary outcomes were changes in reporting patterns and perceptions after distribution of incentives. RESULTS Two hundred and eighteen surgical patients were identified in the incidents reported. Financial incentives significantly increased incidents reported (35 to 183) by physicians (37.1% to 67.8%; P < 0.001) and physician assistants (2.9% to 18.6%; P < 0.001). Acute care surgery displayed the largest increase in incidents reported among surgical specialties (5.7% to 20.2%; P = 0.040). Surgeons exhibited an increase in reporting (60.0% to 94.5%; P < 0.001) compared with witnesses after incentivization (2.9% to 1.6%). CONCLUSIONS Financial incentives were associated with increased incident reporting. After the establishment of incentives, physicians were more likely to report their incidents, which may dispel professional embarrassment and display incident ownership. Institutions must encourage reporting while supporting providers. Future quality-improvement studies targeting reporting should incorporate incentives aimed to engage and empower health-care providers.
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Affiliation(s)
| | - Alex Addo
- Department of Surgery, Anne Arundel Medical Center, Annapolis, Maryland
| | - Paul Kim
- Department of Surgery, Anne Arundel Medical Center, Annapolis, Maryland
| | - Justin Turcotte
- Department of Surgery, Anne Arundel Medical Center, Annapolis, Maryland
| | - Adrian Park
- Department of Surgery, Anne Arundel Medical Center, Annapolis, Maryland.
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Alsaleh FM, Alsaeed S, Alsairafi ZK, Almandil NB, Naser AY, Bayoud T. Medication Errors in Secondary Care Hospitals in Kuwait: The Perspectives of Healthcare Professionals. Front Med (Lausanne) 2021; 8:784315. [PMID: 34988097 PMCID: PMC8720773 DOI: 10.3389/fmed.2021.784315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/01/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives: Medication errors (MEs) are the most common cause of adverse drug events (ADEs) and one of the most encountered patient safety issues in clinical settings. This study aimed to determine the types of MEs in secondary care hospitals in Kuwait and identify their causes. Also, it sought to determine the existing system of error reporting in Kuwait and identify reporting barriers from the perspectives of healthcare professionals (HCPs). Material and Methods: A descriptive cross-sectional study was conducted using a pre-tested self-administered questionnaire. Full-time physicians, pharmacists, and nurses (aged 21 years and older) working in secondary care governmental hospitals in Kuwait were considered eligible to participate in the study. Descriptive statistics and the Statistical Package for Social Science Software (SPSS), version 27 were used to analyze the data. Results: A total of 215 HCPs were approached and asked to take part in the study, of which 208 agreed, giving a response rate of 96.7%. Most HCPs (n = 129, 62.0%) reported that the most common type of ME is “prescribing error,” followed by “compliance error” (n = 83; 39.9%). Most HCPs thought that a high workload and lack of enough breaks (n = 128; 61.5%) were the most common causes of MEs, followed by miscommunication, either among medical staff or between staff and patients, which scored (n = 89; 42.8%) and (n = 82; 39.4%), respectively. In the past 12 months, 77.4% (n = 161) of HCPs reported that they did not fill out any ME incident reports. The lack of feedback (n = 65; 31.3%), as well as the length and complexity of the existing incident reporting forms (n = 63; 30.3%), were the major barriers against reporting any identified MEs. Conclusions: MEs are common in secondary care hospitals in Kuwait and can be found at many stages of practice. HCPs suggested many strategies to help reduce MEs, including proper communication between HCPs; double-checking every step of the process before administering medications to patients; providing training to keep HCPs up to date on any new treatment guidelines, and computerizing the health system.
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Affiliation(s)
- Fatemah M. Alsaleh
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Hawalli, Kuwait
- *Correspondence: Fatemah M. Alsaleh
| | - Sara Alsaeed
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Hawalli, Kuwait
| | - Zahra K. Alsairafi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Hawalli, Kuwait
| | - Noor B. Almandil
- Department of Clinical Pharmacy Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Tania Bayoud
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Hawalli, Kuwait
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11
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Zhu L, Reychav I, McHaney R, Broda A, Tal Y, Manor O. Extension to 'combined SNA and LDA methods to understand adverse medical events': Doctor and nurse perspectives. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2021; 31:221-246. [PMID: 32538872 DOI: 10.3233/jrs-190031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Physicians and nurses are responsible for reporting medical adverse events. Each views these events through a different lens subject to their role-based perceptions and barriers. Physicians typically engage with diagnosis and treatment while nurses primarily care for patients' daily lives and mental well-being. This results in reporting and describing medical adverse events differently. OBJECTIVE We aimed to compare adverse medical event reports generated by physicians and nurses to better understand the differences and similarities in perspective as well as the nature of adverse medical events using social network analysis (SNA) and latent Dirichlet allocation (LDA). METHODS The current study examined data from the Maccabi Healthcare Community. Approximately 17,868 records were collected from 2000 to 2017 regarding medical adverse events. Data analysis used SNA and LDA to perform descriptive text analytics and understand underlying phenomenon. RESULTS A significant difference in harm levels reported by physicians and nurses was discovered. Shared topic keyword lists broken down by physicians and nurses were derived. Overall, communication, lack of attention, and information transfer issues were reported in medical adverse events data. Specialized keywords, more likely to be used by a physician were determined as: repeated prescriptions, diabetes complications, and x-ray examinations. For nurses, the most common special adverse event behavior keywords were vaccine problem, certificates of fitness, death and incapacity, and abnormal dosage. CONCLUSIONS Communication and inattentiveness appeared most frequently in medical adverse events reports regardless of whether doctors or nurses did the reporting. Findings suggest feedback and information sharing processes could be implemented as a step toward alleviating many issues. Institutional management, healthcare managers and government officials should take actions to decrease medical adverse events, many of which may be preventable.
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Affiliation(s)
- Lin Zhu
- Industrial Engineering & Management Department, Ariel University, Ariel, Israel
| | - Iris Reychav
- Industrial Engineering & Management Department, Ariel University, Ariel, Israel
| | - Roger McHaney
- Daniel D. Burke Chair for Exceptional Faculty, Management Information Systems, Kansas State University, Manhattan, KS, USA
| | - Arik Broda
- Risk Management Department, Maccabi Healthcare Services, Israel
| | - Yossi Tal
- Risk Management Department, Maccabi Healthcare Services, Israel
| | - Orly Manor
- Risk Management Department, Maccabi Healthcare Services, Israel
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12
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Mohamed MFH, Abubeker IY, Al-Mohanadi D, Al-Mohammed A, Abou-Samra AB, Elzouki AN. Perceived Barriers of Incident Reporting Among Internists: Results from Hamad Medical Corporation in Qatar. Avicenna J Med 2021; 11:139-144. [PMID: 34646790 PMCID: PMC8500080 DOI: 10.1055/s-0041-1734386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background
Adverse events (AE) are responsible for annual deaths that exceed deaths due to motor vehicle accidents, breast cancer, and AIDS. Many AE are considered preventable. Thus, AE needs to be detected and analyzed. Incident reporting systems (IRS) are crucial in identifying AE. Nevertheless, the incident report (IR) process is flawed with underreporting, especially from the physicians' side. This limits its efficiency in detecting AE. Therefore, we aimed to assess the practice and identify the barriers associated with incident reporting among internal medicine physicians in a large tertiary hospital through a survey.
Methods
A cross-sectional descriptive study. We distributed an online survey to physicians working in the Internal Medicine Department of Qatar's largest tertiary academic institute. The questionnaire was validated and piloted ahead of the start of the trial. The response rate was 53%.
Results
A total of 115 physicians completed the survey; 59% acknowledged the availability of an institutional IRS. However, only 29% knew how to submit an online IR, and 20% have ever submitted an IR. The survey revealed that participants were less likely to submit an IR when they or a colleague is involved in the incident; 46% and 63%, respectively. The main barriers of reporting incidents were unawareness about the IRS (36%) and the perception that IR will not bring a system change (13%); moreover, there exists the fear of retaliation (13%). When asked about solutions, 57% recommended training and awareness, and 22% recommended sharing learnings and actions from previous IR.
Conclusions
IRS is underutilized by internal medicine physicians. The main barrier at the time of the survey is the lack of training and awareness. Promoting awareness and sharing previous learning and actions may improve the utilization of the IRS.
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Affiliation(s)
- Mouhand F H Mohamed
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ibrahim Y Abubeker
- Department of Medicine, Brown Internal Medicine Residency, Brown University, Providence, Rhode Island, United States
| | - Dabia Al-Mohanadi
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Al-Mohammed
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Abdul-Badi Abou-Samra
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Abdel-Naser Elzouki
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medical College, Doha, Qatar.,Department of Medicine, College of Medicine, Qatar University, Doha, Qatar
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13
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Woo MWJ, Avery MJ. Nurses' experiences in voluntary error reporting: An integrative literature review. Int J Nurs Sci 2021; 8:453-469. [PMID: 34631996 PMCID: PMC8488811 DOI: 10.1016/j.ijnss.2021.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/26/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This integrative review aimed to examine and understand nurses' experiences of voluntary error reporting (VER) and elucidate factors underlying their decision to engage in VER. METHOD This is an integrative review based on Whittemore & Knafl five-stage framework. A systematic search guided by the PRISMA 2020 approach was performed on four electronic databases: CINAHL, Medline (PubMed), Scopus, and Embase. Peer-reviewed articles published in the English language from January 2010 to December 2020 were retrieved and screened for relevancy. RESULTS Totally 31 papers were included in this review following the quality appraisal. A constant comparative approach was used to synthesize findings of eligible studies to report nurses' experiences of VER represented by three major themes: nurses' beliefs, behavior, and sentiments towards VER; nurses' perceived enabling factors of VER and nurses' perceived inhibiting factors of VER. Findings of this review revealed that nurses' experiences of VER were less than ideal. Firstly, these negative experiences were accounted for by the interplays of factors that influenced their attitudes, perceptions, emotions, and practices. Additionally, their negative experiences were underpinned by a spectrum of system, administrative and organizational factors that focuses on attributing the error to human failure characterized by an unsupportive, blaming, and punitive approach to error management. CONCLUSION Findings of this review add to the body of knowledge to inform on the areas of focus to guide nursing management perspectives to strengthen institutional efforts to improve nurses' recognition, reception, and contribution towards VER. It is recommended that nursing leaders prioritize and invest in strategies to enhance existing institutional error management approaches to establish a just and open patient safety culture that would promote positivity in nurses' overall experiences towards VER.
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Affiliation(s)
- Ming Wei Jeffrey Woo
- School of Health & Social Sciences, Nanyang Polytechnic, Singapore
- Department of Health Services Management, School of Medicine, Griffith University, Brisbane, Australia
| | - Mark James Avery
- Department of Health Services Management, School of Medicine, Griffith University, Brisbane, Australia
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14
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Dhamanti I, Leggat S, Barraclough S. Practical and Cultural Barriers to Reporting Incidents Among Health Workers in Indonesian Public Hospitals. J Multidiscip Healthc 2020; 13:351-359. [PMID: 32308408 PMCID: PMC7138616 DOI: 10.2147/jmdh.s240124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/25/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study investigated the practical and cultural barriers of reporting patient safety incidents in three accredited public hospitals in East Java, Indonesia. METHODS This study employed a mixed methods approach using a convergent parallel design. We surveyed 1121 health workers and interviewed 27 managerial staff members from the sampled hospitals. A chi-square analysis was performed to evaluate differences in demographic factors, barriers to reporting, and practices of reporting between those who had reported an incident and those who had witnessed an incident but had not reported it. NVivo 11 software was used to perform the qualitative data analysis. RESULTS This study had a 76.53% response rate. The quantitative evaluation identified significant differences in professions and work units and in participation in quality and safety training between the reporting group and the non-reporting group. The analysis of practical barriers displayed significant differences between the groups with the following responses: "did not know how to report," "did not know where to report," and "lack of feedback". For cultural barriers, a significant difference was shown only for the response "did not want conflict." In the qualitative assessment, most of the interview participants reported lack of knowledge and lack of socialization or training as practical barriers in reporting incidents. Furthermore, reluctance and fear to report were mentioned as cultural barriers by most of the interviewees. CONCLUSION Because there were conflicting findings in the barriers of reporting incidents, these barriers must be identified, discussed, and resolved by health workers and their managers or supervisors to improve incident reporting. Managers must foster open communication and build positive connections with health workers. Further research is necessary to focus on possible ways of addressing the barriers to reporting.
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Affiliation(s)
- Inge Dhamanti
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
- Center for Patient Safety Research, Universitas Airlangga, Surabaya, Indonesia
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Sandra Leggat
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Simon Barraclough
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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15
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Sultan WIM, Sultan MIM, Crispim J. Palestinian doctors' views on patient-centered care in hospitals. BMC Health Serv Res 2018; 18:766. [PMID: 30305081 PMCID: PMC6180518 DOI: 10.1186/s12913-018-3573-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 09/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding the perceived importance of Patient-Centered Care (PCC) among Palestinian doctors and how the provider and other clinical characteristics may impact their views on PCC is essential to determine the extent to which PCC can be implemented. This study investigates the provision of PCC among hospital doctors in a developing and unstable country, namely, Palestine. METHODS This descriptive, cross-sectional research employed self-report survey among 369 Palestinian doctors working in hospitals in 2016. Respondents completed the Provider-Patient Relationship Questionnaire (PPRQ) and were asked to rate the importance of 16 PCC subjects in a context-free manner. Then they scored the existence of eight contextual attributes in their workplace. RESULTS Although 71.4% of the participants got training in communication, only 45% of the participants knew about PCC. 48.8% of doctors considered the "exchange of information" with patients most important PCC component. Clustering identified three groups of doctors: 32.4% of doctors reported good perceptions of PCC, 47.5% moderate; and 20.1% poor. Older, married, and specialist doctors and those familiar with PCC are more likely classified in the "good" cluster. Results revealed a significant difference between doctors' views based on their gender, experience, marital status, previous knowledge about PCC, and type of hospital in favor of males, experienced, married, familiar with PCC, and doctors in private hospital respectively. The level of job interest, nurses' cooperation, the tendency of patients to hide information, and doctor's friendly style were positively related with more perceived importance of PCC. CONCLUSION We identified benchmark doctors who perceive the high relative importance of PCC. Our results highlighted knowledge gaps and training weaknesses among doctors in public and private hospitals in respect to their views on PCC. Decision makers may invest in the determined contextual predictors to enhance attitudes towards PCC. This work doesn't address patients' views on PCC.
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Affiliation(s)
- Wasim I M Sultan
- School of Administrative Sciences, PPU-Palestine & NIPE-Portugal, Hebron, Palestine.
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16
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Lee W, Kim SY, Lee SI, Lee SG, Kim HC, Kim I. Barriers to reporting of patient safety incidents in tertiary hospitals: A qualitative study of nurses and resident physicians in South Korea. Int J Health Plann Manage 2018; 33:1178-1188. [PMID: 30160794 DOI: 10.1002/hpm.2616] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 02/26/2018] [Accepted: 06/29/2018] [Indexed: 11/06/2022] Open
Abstract
We explored the barriers to reporting patient safety incidents experienced by nurses and resident physicians while working in tertiary hospitals in South Korea. Sixteen in-depth interviews with 10 nurses and 6 resident physicians, all of whom had experienced patient safety incidents, were conducted. The interviews were analyzed using directed content analysis in accordance with a coding scheme developed in this study, which contains 4 categories (incidents and reporters, reporting procedures and systems, feedbacks, and reporting culture) and 9 subcategories. The barriers to reporting near-misses included the following: characteristics of the incident (eg, nonhazardous and high frequency), reporters' lack of knowledge, uncertainty, fear of blame, lack of role model, and inappropriate responses. Reporting adverse/sentinel events was also prevented by feelings of pressure or guilt, the fact that reporting was nonmandatory, and a belief that reporting was not part of the job. Some other barriers included lack of education, review process after reporting, lack of confidentiality when reporting, absence of feedback for reporting, unfair reporting based on work experience, perception of potential blame, and stigmatization resulting from it. In South Korea, a national system for reporting and learning of patient safety accidents has been operating since July 2016. To fully implement this system, it is necessary to encourage reporting at the institutional level. Our results might help reduce the barriers to patient safety incident reporting among nurses and resident physicians in tertiary hospitals in Korea through informing the development of improvement plans.
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Affiliation(s)
- Won Lee
- Division of Medical Law and Bioethics, Department of Medical Humanities and Social Sciences, College of Medicine, Asian Institute for Bioethics and Health Law, Yonsei University, Seoul, South Korea
| | - So Yoon Kim
- Division of Medical Law and Bioethics, Department of Medical Humanities and Social Sciences, College of Medicine, Asian Institute for Bioethics and Health Law, Yonsei University, Seoul, South Korea
| | - Sang-Il Lee
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sun Gyo Lee
- Office for Asan Global Standard Implementation, Asan Medical Center, Seoul, South Korea
| | - Hyung Chul Kim
- Department of Philosophy, Asian Institute for Bioethics and Health Law, Yonsei University, Seoul, South Korea
| | - Insook Kim
- College of Nursing, Moim Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
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17
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Sundler AJ, Johansson E, Johansson L, Hedén L. Incidents reported by nurse anaesthetists in the operating room. J Interprof Care 2018; 32:699-705. [DOI: 10.1080/13561820.2018.1500452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Annelie J. Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | | | - Linda Johansson
- Anaesthesia and intensive care unit, Hallands Sjukhus, Varberg, Sweden
| | - Lena Hedén
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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18
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Sultan WIM, Crispim J. Measuring the efficiency of Palestinian public hospitals during 2010-2015: an application of a two-stage DEA method. BMC Health Serv Res 2018; 18:381. [PMID: 29843732 PMCID: PMC5975658 DOI: 10.1186/s12913-018-3228-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 05/23/2018] [Indexed: 12/05/2022] Open
Abstract
Background While health needs and expenditure in the Occupied Palestinian Territories (OPT) are growing, the international donations are declining and the economic situation is worsening. The purpose of this paper is twofold, to evaluate the productive efficiency of public hospitals in West Bank and to study contextual factors contributing to efficiency differences. Methods This study examined technical efficiency among 11 public hospitals in West Bank from 2010 through 2015 targeting a total of 66 observations. Nationally representative data were extracted from the official annual health reports. We applied input-oriented Data Envelopment Analysis (DEA) models to estimate efficiency scores. To elaborate further on performance, we used Tobit regression to identify contextual factors whose impact on inefficient performance is statistically significant. Results Despite the increase in efficiency mean scores by 4% from 2010 to 2015, findings show potential savings of 14.5% of resource consumption without reducing the volume of the provided services. The significant Tobit model showed four predictors explaining the inefficient performance of a hospital (p < 0.01) are: bed occupancy rate (BOR); the outpatient-inpatient ratio (OPIPR); hospital’s size (SIZE); and the availability of primary healthcare centers within the hospital’s catchment area (PRC). There is a strong effect of OPIPR on efficiency differences between hospitals: A one unit increase in OPIPR will lead a decrease of 19.7% in the predicted inefficiency level holding all other factors constant. Conclusion To date, no previous studies have examined the efficiency of public hospitals in the OPT. Our work identified their efficiency levels for potential improvements and the determinants of efficient performance. Based on the measurement of efficiency, the generated information may guide hospitals’ managers, policymakers, and international donors improving the performance of the main national healthcare provider. The scope of this study is limited to public hospitals in West Bank. For a better understanding of the Palestinian market, further research on private hospitals and hospitals in Gaza Strip will be useful. Electronic supplementary material The online version of this article (10.1186/s12913-018-3228-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wasim I M Sultan
- School of Economics and Management, University of Minho, 4710-057, Braga, Portugal. .,, P.O. Box 198, Hebron, Palestine.
| | - José Crispim
- School of Economics and Management, University of Minho, 4710-057, Braga, Portugal
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19
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Hong S, Li Q. The reasons for Chinese nursing staff to report adverse events: a questionnaire survey. J Nurs Manag 2017; 25:231-239. [PMID: 28244248 DOI: 10.1111/jonm.12461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Su Hong
- The 2 Affiliated Hospital & College of Nursing; Harbin Medical University; Harbin China
| | - QiuJie Li
- The 2 Affiliated Hospital & College of Nursing; Harbin Medical University; Harbin China
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