The Patient Safety Culture Scale for Chinese Primary Health Care Institutions: Development, Validity and Reliability

Assessment of patient safety culture in Moroccan primary health care: a multicentric study

BACKGROUND

Promoting patient safety is a critical concern for developing-countries health systems like Morocco. There is an increasing acknowledgment of the need to create a patient-centered culture with the aim to decrease the number of adverse events related to care and improve health-care quality in Morocco.

OBJECTIVE

The purpose of this study is to examine the perceptions of health professionals working in primary care level of care facilities in Morocco about the concept of patient safety culture.

METHODS

We conducted a multicentric cross-sectional study of a quantitative nature in primary healthcare facilities in ten Moroccan cities, measuring ten patient safety culture dimensions, from February 2022 to June 2022. Data was collected using the French version of the HSOPSC questionnaire.

RESULTS

The most developed dimension of the culture of patient safety was found to be Teamwork within Units (69%), followed by Supervisor/Manager's Expectations & Actions Promoting Patient Safety (59%). The least developed dimensions were Staffing (34%) and Nonpunitive Response to Errors (37%).

CONCLUSION

Improving patient safety culture should be a priority for primary healthcare facility administrators and all stakeholders, addressing, in particular, the shortage of human resources. In addition, health personnel should be encouraged to report errors without fear of punitive consequences.

Concept analysis of patient safety in home care: a hybrid model

BACKGROUND

Patient safety in home care is a fundamental and complex concept in nursing. This concept includes a number of challenges in patient care. Studies have shown that there is no clear and uniform definition for this concept.

OBJECTIVE

The objective of the present study was to analyse patient safety in home care in Iran.

METHODS

The study was done using a hybrid model at three phases, including theoretical, field work and the final analysis. We searched valid databases including MEDLIN and CINHAL; electronic references including Web of Science, Scopus, Ovid, ProQuest, PubMed and Persian databases including Magiran, IranDoc and SID during 2008-2022, using these Persian and English keywords: Patient Safety, Safety, Home Care Service, Domiciliary Care, Home Care and Home Health Care. A total of 16 articles were searched in the theoretical phase and then analysed by content analysis. In field work phase, nine participants were interviewed (nurse, family and patient) and then the interviews were analysed by the content analysis method. In the final analysis phase, a general analysis of the previous two phases was performed and after determining the attributes, antecedents and consequences, a final definition of patient safety in home care in Iran was presented.

FINDINGS

Based on different studies, patient safety in home care is a multifaceted concept, which encompasses physical, mental, social and practical dimensions. Evaluation, prevention, participation and commitment to the safety culture are the core features of this concept. The patient care concept depends on the commitment of the involved participants, adequate resources, environmental conditions, support of the involved centres (home care agency, hospital and the insurance), self-efficacy and the ability of the caregivers (nurses).

CONCLUSION

Defining the concept of patient safety in home care provides a basis for the development of a safe patient care system at home. This concept analysis for patient safety in home care could be a guide for future studies.

Open pollution routing problem of logistics distribution in medical union based on differential search algorithm

Medical care is a guarantee of people's daily life. Improving healthcare contributes to people's well-being. However, healthcare resources are characterized by uneven distribution. Financially well-off areas will have higher quality health care resources. Most of the medical resources are concentrated in public general hospitals, however, primary care institutions can hardly meet the growing needs of people. To solve this problem, Medical Union achieves efficient deployment of resources by integrating various medical institutions in the same area. In the process of logistics integration of the medical union, the scale of logistics distribution expands accordingly. Transportation vehicles have high operating costs and produce greenhouse gases in the process of distribution. The optimization of the driving path of logistics distribution vehicles can reduce the operating cost, fuel consumption and carbon emission. To solve this kind of decentralized and complex vehicle routing problem, this paper proposes a pollution routing problem model considering electrical vehicle usage, customer's soft time window expectation, open path and carbon cost. A modified Differential Search Algorithm with the comprehensive learning strategy and dynamic Cauchy variation strategy is advanced to solve the problem. Results show that the improved algorithm has good solving performance, and verifies the rationality of the proposed model, which will help to reduce carbon emissions and save the logistics and operating costs of medical devices.

Attitudes and Response Capacities for Public Health Emergencies of Healthcare Workers in Primary Healthcare Institutions: A Cross-Sectional Investigation Conducted in Wuhan, China, in 2020

OBJECTIVES

Response capacities for public health emergencies (PHEs) amongst healthcare workers play important roles in the prevention and control of PHEs. This study assessed the attitudes and response capacities of PHE workers in primary healthcare (PHC) institutions.

METHODS

An online anonymous questionnaire survey of 803 healthcare workers sampled from 13 PHC institutions in Wuhan, China, was conducted from April to June 2020. The Kruskal-Wallis test and linear regression model were used to analyze the response capacities of PHE workers and associated factors.

RESULTS

The healthcare workers with longer working years, particularly 30 years and above, had higher knowledge (OR = 7.323, p < 0.001) and practical ability scores (OR = 8.012, p < 0.001) when compared to those with less than 5 working years. The nurses had higher practical ability scores (OR = 2.188, p = 0.049), and pharmacists had lower practical ability scores (OR = 0.166, p = 0.007), when compared to doctors. Moreover, the healthcare workers who had never participated in educational activities related to PHE management in the past two years (OR = 0.540, p = 0.038; OR = 0.282, p = 0.001), had not participated in a PHE drill activity (OR = 0.327, p < 0.001; OR = 0.340, p = 0.004), and had never been involved in emergency management of PHEs (OR = 0.254, p < 0.001; OR = 0.174, p < 0.001) had lower knowledge and practical ability scores.

CONCLUSION

The healthcare workers with longer working years had better response capacities, and nurses had better practical abilities when compared to doctors. More emergency management education and chances to be involved in PHE drill activities were encouraged amongst healthcare workers in PHC institutions for better prevention and control of PHEs. Moreover, inter-institution cooperation, a flexible response system, and dynamic adjustment of healthcare workers were suggested during PHEs.

Development and Validation of the Veterans Health Administration Patient Safety Culture Survey

RATIONALE, AIMS, AND OBJECTIVES

Patient safety culture (PSC) is an important concept in healthcare organization, and measuring it can lead to improved patient safety event reporting. We sought to test and validate an abbreviated version of a PSC measure within the Veterans Health Administration (VHA).

METHODS

An initial set of 34 items was identified to represent the VHA Patient Safety Culture Survey (VHA-PSCS). The items were administered as part of an annual survey administration in June 2019 (N = 205,117, 66.1% response rate). We derived a split-half sample and conducted exploratory and confirmatory factor analysis to identify factors. We examined reliability along with construct and criterion validity of the VHA-PSCS in relation to other workplace attitudes and behaviors.

RESULTS

The final instrument includes 20 items with 4 scales derived from factor analysis: (a) risk identification and just culture; (b) error transparency and mitigation; (c) supervisor communication and trust; and (d) team cohesion and engagement. Reliability was supported based on Cronbach α coefficients and split-half testing. For criterion validity, Spearman correlations were greater than 0.40 between VHA-PSCS scales and employee satisfaction and intrinsic work experience. Correlations were greater than 0.20 between VHA-PSC scales and intent to leave, burnout, and self-rated reporting of error incidents.

CONCLUSIONS

The VHA-PSCS reflects 4 dimensions of patient safety. The instrument can be used to benchmark and compare progress of VHA's PSC transformation across the organization and within medical centers, to strengthen patient safety event reporting, investigation, and quality of care.

A Scale to Measure the Joy in Work of Doctors: Development, Validity, and Reliability

Background: The aim of this study is to develop a scale and evaluate its' validity and reliability to measure the joy in work of doctors. Methods: Based on literature review and panel discussion, the scale framework and item pool were determined. Next, the items were modified by two rounds of expert consultation. Then the pre-investigation was applied and the formal version of scale was formed. Last, the reliability and validity of the scale were tested with 426 physicians. Results: The scale was composed of four dimensions: work autonomy needs, competency identification needs, competency perception needs and work relationship needs. Each dimension had 7 items, and both reliability and validity were acceptable. The Cronbach α coefficient and half-reliability coefficient of the whole scale were 0.954 (>0.9) and 0.974 (>0.9). The Spearman correlations of item-total score ranged from 0.556 to 0.749, indicating a good-item total score correlation. The χ 2/ df, RMSEA, RMR, GFI, CFI, and TLI, CFA of the maximum likelihood method supported a good fit with the model. Conclusions: Based on the self-determination theory, this study develops a scale to measure the joy in work of doctors. It has good validation and reliability, which is useful for doctors and medical institutions to take steps to improve happiness.

Effectiveness of New Tools to Define an Up-to-Date Patient Safety Risk Map: A Primary Care Study Protocol

Background: Reducing incidents related to health care interventions to improve patient safety is a health policy priority. To strengthen a culture of safety, reporting incidents is essential. This study aims to define a patient safety risk map using the description and analysis of incidents within a primary care region with a prior patient safety improvement strategy organisationally developed and promoted. Methods: The study will be conducted in two phases: (1) a cross-sectional descriptive observational study to describe reported incidents; and (2) a quasi-experimental study to compare reported incidents. The study will take place in the Camp de Tarragona Primary Care Management (Catalan Institute of Health). In Phase 1, all reactive notifications collected within one year (2018) will be analysed; during Phase 2, all proactive notifications of the second and third weeks of June 2019 will be analysed. Adverse events will also be assessed. Phases 1 and 2 will use a digital platform and the proactive tool proSP to notify and analyse incidents related to patient safety. Expected Results: To obtain an up-to-date, primary care patient safety risk map to prioritise strategies that result in safer practices.

Development and validation of the cancer symptoms discrimination scale: a cross-sectional survey of students in Yunnan, China

Background

This study aimed to devise a Cancer symptoms Discrimination Scale (CSDS) suitable for China based on a cross-sectional survey.

Methods

The CSDS was developed using the classical measurement theory. A total of 3610 students from Yunnan province, China, participated in the cross-sectional survey. The test version of the scale was modified by the item analysis method, and after the official version of CSDS was developed, its reliability and validity were verified. A univariate analysis of variance and a multiple linear regression model were used to analyze the influencing factors of cancer symptoms discrimination among the university/college students.

Results

There were 21 items in total for the CSDS, including 3 subscales --- common clinical manifestations (11 items), physical appearance defects (6 items), and drainage tube(s) wearing (4 items). This CSDS had good validity (GFI = 0.930, AGFI = 0.905, RMR = 0.013, I-CVIs> 0.80, and the Pearson correlation coefficient was satisfactory.) and reliability (Cronbach’s alpha = 0.862, spearman-brown coefficient = 0.875). The multiple linear regression showed that certain factors may affect the students’ discrimination level against cancer symptoms (P < 0.05), including gender, major, current education degree, guardian’s highest record of formal schooling, self-rated health status, history of care for cancer patients, family relationship, ways of cancer knowledge acquisition, good/poor understanding of cancer-related information, degree of cancer fear, and their perception of cancer infectiousness.

Conclusion

This CSDS, with good reliability and validity, can be used for the evaluation of the discrimination risk and levels against cancer symptoms among healthy students.

Psychological distress in the shadow of the COVID-19 pandemic: Preliminary development of an assessment scale

COVID-19 is now spreading worldwide, and poses some public mental health problems which requires close attention. This study aims to develop a scale of COVID-19 related psychological distress in healthy public (CORPD) to assess the severity of psychological distress in uninfected healthy populations. We compiled a 14-item scale which contains two dimensions- Anxiety & fear and Suspicion -using the classical measurement theory. 652 Chinese citizens consented and completed a survey through an online questionnaire APP. The reliability test showed that the scale had good internal consistency reliability and Split-Half reliability, and the validity test showed that it had good structure validity, content validity and criterion correlation validity. This scale can be used to assess the psychological distress of people in China and in other COVID-19-hit regions and countries. It also provides a reference for future studies on COVID-19 or other respiratory infectious diseases related public mental health.