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Li S, Hou S, Deng X, Chen S, Wang H, Tang L, Ye M, Xie J. Reliability and validity assessment of the Chinese version of the Intrahospital Transport Safety Scale (IHTSS) in intensive care units. BMC Nurs 2024; 23:296. [PMID: 38684975 PMCID: PMC11057123 DOI: 10.1186/s12912-024-01906-z] [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: 07/10/2023] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Intrahospital transport of critically ill patients is a common practice in intensive care units (ICUs), where patients' safety is constantly challenged in high-intensity and dynamic environments. While Intrahospital Transport Safety Scale (IHTSS) is widely used internationally to evaluate the intrahospital transport safety, it has not been introduced in China. OBJECTIVES This study aimed to assess the reliability and validity of the Chinese version of the IHTSS scale among critical care nurses in China. METHODS A cross-sectional study was conducted using a cluster sampling method. A total of 544 critical care nurses from 25 ICUs in 10 tertiary hospitals were recruited. We employed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine the questionnaire's underlying factor structure, ensuring construct validity. Additionally, internal consistency was assessed using Cronbach's alpha coefficient, test-retest reliability, and corrected item-total correlation. RESULTS The Chinese version of the scale displayed robust psychometric properties, with a Cronbach's α coefficient of 0.976, a split-half reliability of 0.906, and a test-retest reliability of 0.856. EFA revealed a robust four-factor model that accounted for 75.970% of the variance, with the factor loadings of the items ranging from 0.433 to 0.951. CFA indicated a strong model fit, with a chi-square to degrees of freedom ratio (CMIN/DF) of 2.765, comparative fit index (CFI) of 0.943, incremental fit index (IFI) of 0.943, and goodness-of-fit index (GFI) of 0.845, supporting the efficacy of the four-factor model in assessing intrahospital transport safety for critically ill patients. CONCLUSION The Chinese version of the IHTSS demonstrated favourable reliability and validity among critical care nurses in China, making it a suitable tool for measuring the level of intrahospital transport safety for critically ill patients.
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Affiliation(s)
- Shuaishuai Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, 410011, Changsha, Hunan, China
- Critical Care Medicine, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China
| | - Shuting Hou
- Department of Nursing, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan children's hospital), No. 86 Ziyuan Road, 410011, Changsha, Hunan, China
| | - Xianjiao Deng
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, 410011, Changsha, Hunan, China
| | - Shihao Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, 410011, Changsha, Hunan, China
| | - Huaqin Wang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, 410011, Changsha, Hunan, China
- Critical Care Medicine, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China
| | - Li Tang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, 410011, Changsha, Hunan, China
- Critical Care Medicine, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China
| | - Man Ye
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, 410011, Changsha, Hunan, China.
| | - Jianhui Xie
- Department of Nursing, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan children's hospital), No. 86 Ziyuan Road, 410011, Changsha, Hunan, China.
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Yuan B, Song S, Tang X, Ma Z. Application of Multidimensional Quality Management Tools in the Management of Medical Adverse Events. Risk Manag Healthc Policy 2024; 17:91-99. [PMID: 38222796 PMCID: PMC10787512 DOI: 10.2147/rmhp.s436083] [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: 08/18/2023] [Accepted: 01/05/2024] [Indexed: 01/16/2024] Open
Abstract
Purpose This study aims to investigate the impact of multidimensional quality management tools in establishing a medical adverse event management system, with the aim of continuously improving medical quality and safety while ensuring patient well-being. Methods This study introduces risk management theories, such as the "Gray Rhino Theory", and employs quality management tools like the Plan-Do-Check-Act (PDCA) cycle, Quality Control Circle (QCC), and Root Cause Analysis (RCA), to provide relevant quality management education and training to employees. This approach facilitates the establishment of a medical adverse event management system that encourages reporting and fosters a blame-free reporting culture, while simultaneously implementing quality management across the entire process. The regular utilization of the QCC facilitates ongoing quality improvement. Furthermore, for sentinel events and patient harm incidents with educational values, the study employs the Incident Decision Tree (IDT) to determine appropriate actions. Additionally, the hospital initiates RCA for system-wide improvements, focusing on areas such as management, institutional processes, and environmental aspects. Moreover, an internal medical quality improvement case competition is organized, with outstanding cases being selected to participate in the multidimensional quality management competition organized by the National Quality Management Alliance. Results The study reveals a significant improvement in employees' awareness of adverse events, the percentage of employees reporting adverse events increased significantly from 39.15% in 2019 to 49.77% in 2022, P=0.002. Furthermore, the adverse event reporting rate has risen significantly from 2.78% (2019) to 5.96% (2022), P=0.002. Additionally, each department has been able to utilize QCC or RCA tools for quality improvement, thereby further reinforcing the development of a patient safety culture. Conclusion Multidimensional quality management tools play a crucial role in establishing a hospital's adverse event management system, promoting continuous improvement in medical quality, ensuring patient safety, and effectively implementing a culture of patient safety.
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Affiliation(s)
- Bei Yuan
- Medical Department, The Second People’s Hospital of Guizhou Province (Guizhou Province Mental Health Center), Guizhou, Guiyang, 550001, People’s Republic of China
| | - Shibei Song
- Medical Department, The Second People’s Hospital of Guizhou Province (Guizhou Province Mental Health Center), Guizhou, Guiyang, 550001, People’s Republic of China
| | - Xiao Tang
- Medical Department, The Second People’s Hospital of Guizhou Province (Guizhou Province Mental Health Center), Guizhou, Guiyang, 550001, People’s Republic of China
| | - Zhanqiang Ma
- Medical Department, The Second People’s Hospital of Guizhou Province (Guizhou Province Mental Health Center), Guizhou, Guiyang, 550001, People’s Republic of China
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Carvalho REFLD, Bates DW, Syrowatka A, Almeida I, Sousa L, Goncalves J, Oliveira N, Gama M, Alencar AP. Factors determining safety culture in hospitals: a scoping review. BMJ Open Qual 2023; 12:e002310. [PMID: 37816540 PMCID: PMC10565149 DOI: 10.1136/bmjoq-2023-002310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 09/09/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVE To evaluate and synthesise the factors determining patient safety culture in hospitals. METHODS The scoping review protocol was based on the criteria of the Joanna Briggs Institute. Eligibility criteria were as follows: (1) empirical study published in a peer-reviewed journal; (2) used methods or tools to assess, study or measure safety culture or climate; (3) data collected in the hospital setting and (4) studies published in English. Relevant literature was located using PubMed, CINAHL, Web of Science and PsycINFO databases. Quantitative and qualitative analyses were performed using RStudio and the R interface for multidimensional analysis of texts and questionnaires (IRaMuTeQ). RESULTS A total of 248 primary studies were included. The most used instruments for assessing safety culture were the Hospital Survey on Patient Safety Culture (n=104) and the Safety Attitudes Questionnaire (n=63). The Maslach Burnout Inventory (n=13) and Culture Assessment Scales based on patient perception (n=9) were used in association with cultural instruments. Sixty-six articles were included in the qualitative analysis. In word cloud and similarity analyses, the words 'communication' and 'leadership' were most prominent. Regarding the descending hierarchical classification analysis, the content was categorised into two main classes, one of which was subdivided into five subclasses: class 1a: job satisfaction and leadership (15.56%), class 1b: error response (22.22%), class 1c: psychological and empowerment nurses (20.00%), class 1d: trust culture (22.22%) and class 2: innovation worker (20.00%). CONCLUSION The instruments presented elements that remained indispensable for assessing the safety culture, such as leadership commitment, open communication and learning from mistakes. There was also a tendency for research to assess patient and family engagement, psychological safety, nurses' engagement in decision-making and innovation.
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Affiliation(s)
| | - David W Bates
- General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ania Syrowatka
- General Internal Medicine and Primary Care, Brigham and Women's Hospital Department of Medicine, Boston, Massachusetts, USA
| | - Italo Almeida
- Health Sciences Centre, Universidade Estadual do Ceara, Fortaleza, Ceará, Brazil
| | - Luana Sousa
- Health Sciences Centre, Universidade Estadual do Ceara - Campus do Itaperi, Fortaleza, Ceará, Brazil
| | - Jaira Goncalves
- Health Sciences Centre, Universidade Estadual do Ceara - Campus do Itaperi, Fortaleza, Ceará, Brazil
| | - Natalia Oliveira
- Health Sciences Centre, Universidade Estadual do Ceara - Campus do Itaperi, Fortaleza, Ceará, Brazil
| | - Milena Gama
- Health Sciences Centre, Universidade Estadual do Ceara - Campus do Itaperi, Fortaleza, Ceará, Brazil
| | - Ana Paula Alencar
- Health Sciences Centre, Universidade Estadual do Ceara - Campus do Itaperi, Fortaleza, Ceará, Brazil
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Zhou L, Li L, Xiao S, Yang N. Concern for Patient Safety Culture of ECMO Team in Emergency Department: A Cross-Sectional Survey. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221129168. [PMID: 36217754 PMCID: PMC9558865 DOI: 10.1177/00469580221129168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To evaluate the patient safety culture status of the ECMO team in the emergency department of a tertiary care hospital. A cross-sectional survey was conducted in the emergency department of Xiangya Hospital from September 1st to 30th, 2021. The Chinese version of HSOPSC electronic questionnaire was administered to all staff involved in ECMO management and initiation. A total of 152 ECMO team members completed the survey. Among the 12 dimensions of patient safety culture, 4 dimensions recorded relatively high positive response rates (>50%): organizational learning-continuous improvement (87.1%), teamwork within units (86.8%), feedback and communication about errors (58.5%), and supervisor/manager expectations and actions promoting patient safety (55.6%). 8 dimensions recorded relatively low positive response rates (<50%): nonpunitive responses to errors (24.1%), hospital handoffs and transitions (27.1%), staffing (28.6%), the frequency of event reporting (32.4%), teamwork across units (33.2%), communication openness (39.7%), management support for patient safety (48.7%), and overall perceptions of patient safety (49.3%). The overall level of patient safety culture was measured at 47.6%. The ECMO team should immediately address issues of nonpunitive responses to errors, hospital handoffs and transitions, and staffing to improve the safety of ECMO. Going forward, the head of the ECMO team should regard patient safety culture as a top priority, improve staff satisfaction, standardize the transfer and handover process, and create a blame-free environment to facilitate event reporting.
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Affiliation(s)
| | - Li Li
- Central South University, Changsha,
China
| | | | - Ning Yang
- Central South University, Changsha,
China,Ning Yang, Department of Emergency
Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha,
Hunan 410008, China.
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Gao X, Yan S, Wu W, Zhang R, Lu Y, Xiao S. Implications from China patient safety incidents reporting system. Ther Clin Risk Manag 2019; 15:259-267. [PMID: 30799925 PMCID: PMC6371930 DOI: 10.2147/tcrm.s190117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective We aimed to explain the operational mechanism of China National Patient Safety Incidents Reporting System, analyze patterns and trends of incidents reporting, and discuss the implication of the incidents reporting to improve hospital patient safety. Design A nationwide, registry-based, observational study design. Data source The database of China National Patient Safety Incidents Reporting System. Outcome measures Outcome measures of this study included the temporal, regional, and hospital distribution of the reports, as well as the incident type, location, parties, and possible reasons for frequently occurring incidents. Results During 2012–2017, 36,498 patient safety incidents were reported. By analyzing the time trends, we found that there was a significant upward trend on incidents reporting in China. The most common type of incidents was drug-related incidents, followed by nursing-related incidents and surgery-related incidents. The three most frequent locations of incident occurrence were Patient’s Room (65.4%), Ambulatory Care Unit (8.4%), and Intensive Care Unit (7.4%). The majority of the incidents involved nurses (40.7%), followed by physicians (29.5%) and medical technologist (13.6%). About 44.4% of the incidents were attributed to the junior staff (work experience ≤5 years). In addition, incidents triggered by the senior staff (work experience >5 years) were more often associated with severe patient harm. Conclusion To strengthen the incidents reporting system and generate useful evidence through learning from incidents reporting will be important to China’s success in improving the nation’s patient safety status.
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Affiliation(s)
- Xinqiang Gao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China,
| | - Shipeng Yan
- Department of Cancer Prevention and Control, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Wenqiong Wu
- Department of Cancer Prevention and Control, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Rui Zhang
- Department of Health Policy and Management, School of Public Health, Peiking University, Peiking, China
| | - Yuliang Lu
- Department of the Medical Affairs, Binzhou Medical University Hospital, Binzhou Medical University, Bingzhou, Shandong Province, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China,
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