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Jiang Y, Cai Y, Zhang X, Wang C. Interprofessional education interventions for healthcare professionals to improve patient safety: a scoping review. MEDICAL EDUCATION ONLINE 2024; 29:2391631. [PMID: 39188239 DOI: 10.1080/10872981.2024.2391631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 07/05/2024] [Accepted: 08/08/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Patient safety incidents, such as adverse events and medical errors, are often caused by ineffective communication and collaboration. Interprofessional education is an effective method for promoting collaborative competencies and has attracted great attention in the context of patient safety. However, the effectiveness of interprofessional education interventions on patient safety remains unclear. This scoping review aimed to synthesize existing studies that focused on improving patient safety through interprofessional education interventions for healthcare professionals. METHODS Six databases, including Medline (via PubMed), Embase, Cochrane Library, CINAHL (via EBSCO), Scopus and Web of Science, were last searched on 20 December 2023. The search records were independently screened by two researchers. The Joanna Briggs Institute Critical Appraisal Tool for Quasi-Experimental Studies was used for quality appraisal. The data were extracted by two researchers and cross-checked. Finally, a narrative synthesis was performed. The protocol for this scoping review was not registered. RESULTS Thirteen quasi-experimental studies with moderate methodological quality were included. The results revealed that the characteristics of current interprofessional education interventions were diverse, with a strong interest in simulation-based learning strategies and face-to-face delivery methods. Several studies did not assess the reduction in patient safety incidents involving adverse events or medical errors, relying instead on the improvements in healthcare professionals' knowledge, attitude or practice related to patient safety issues. Less than half of the studies examined team performance, based primarily on the self-evaluation of healthcare professionals and observer-based evaluation. There is a gap in applying newer tools such as peer evaluation and team-based objective structured clinical evaluation. CONCLUSION Additional evidence on interprofessional education interventions for improving patient safety is needed by further research, especially randomized controlled trials. Facilitating simulation-based interprofessional education, collecting more objective outcomes of patient safety and selecting suitable tools to evaluate teamwork performance may be the focus of future studies.
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Affiliation(s)
- Yan Jiang
- Department of Neurosurgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
- Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Evidence-based Nursing Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Cai
- Evidence-based Nursing Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xue Zhang
- West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Cong Wang
- Evidence-based Nursing Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Noghrehchi P, Hefner JL, Walker DM. The relationship between hospital patient safety culture and performance on Centers for Medicare & Medicaid Services value-based purchasing metrics. Health Care Manage Rev 2024; 49:281-290. [PMID: 39104010 DOI: 10.1097/hmr.0000000000000414] [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: 08/07/2024]
Abstract
BACKGROUND Despite the intense policy focus on reducing health-care-associated conditions, adverse events in health care settings persist. Therefore, evaluating patient safety efforts and related health policy initiatives remains critical. PURPOSE The aim of this study was to explore the relationship between hospital patient safety culture and hospital performance on Centers for Medicare & Medicaid Services (CMS) Hospital Value-Based Purchasing (HVBP) metrics. METHODOLOGY/APPROACH A pooled cross-sectional study design was used utilizing three secondary datasets from 2018 and 2021: the Hospital Survey on Patient Safety Culture, the American Hospital Association annual survey, and the Hospital Compare data from CMS. We used two multivariable linear regression models to examine the relationship between organizational patient safety culture and hospital performance. The dependent variables included the overall CMS total performance score (TPS) and the four individual TPS domain scores. Hospital patient safety culture, the independent variable, was operationalized using two measures from the Hospital Survey on Patient Safety Culture: (a) the domain score of overall perceptions of patient safety and (b) the patient safety grade. RESULTS We observed positive and significant associations between hospital patient safety culture and a hospital's overall TPS and the "patient and community engagement" and "safety" domains. CONCLUSION Findings suggest that building a strong patient safety culture has the potential to lead health care organizations to achieve high performance on HVBP metrics. PRACTICE IMPLICATIONS Our findings have important policy implications for both the future of CMS HVBP as a motivator of patient safety and how health care managers integrate culture change into programs to meet external quality metrics.
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Algethami F, Alasmari AS, Alessa MK, Alhamid AA, Ateeq MK, Alsulami H, Elmorsy SA, Alruwaili SF. Patient safety culture in a tertiary care hospital in Makkah, Saudi Arabia, a cross-sectional study. BMC Health Serv Res 2024; 24:883. [PMID: 39095905 PMCID: PMC11297718 DOI: 10.1186/s12913-024-11310-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/12/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Patient safety remains an area of global concern, and patient safety culture among healthcare staff is one of its most important determinants. Saudi Arabia is investing much effort in enhancing patient safety. Assessment of patient safety culture is enlightening about the impact of such efforts and invaluable in informing policy makers about future directions. This study aimed to assess patient safety culture in King Abdullah Medical City (KAMC), a tertiary referral center in Makkah, Saudi Arabia. METHODS In this cross-sectional study the Hospital Survey on Patient Safety Culture (HSOPSC) version 2.0 was distributed electronically to all staff of KAMC. The HSOPSC version 2.0 Data Entry and Analysis Tool was used to compare results obtained from KAMC to those obtained from global data. Additional analyses were performed on SPSS to explore the presence of associations between responses and participant characteristics. RESULTS A total of 350 participants completed the questionnaire, 58.6% of whom were nurses. A comparison of the composite measure of all 10 domains of the HSOPSC showed 62% positive responses at KAMC versus 70% in the global database. This difference was statistically significant, with a chi-square of 10.64 and a p value of 0.001. The percentages of positive responses from the KAMC data exceeded those from the global data in the "Organizational learning and continuous improvement" and the "Communication about error" domains (p = 0.002 and 0.003, respectively). CONCLUSION Although safety culture seems to score lower at KAMC than globally, accelerated improvement in the future is expected based on improvement trends in the literature and the national efforts focused on patient safety.
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Affiliation(s)
- Faiza Algethami
- Consultant, King Abdullah Medical City, Makkah, Saudi Arabia.
| | | | | | | | | | | | - Soha Aly Elmorsy
- Department of Medical Pharmacology, Faculty of Medicine, Cairo University, Cairo, Egypt.
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Tokede B, Yansane A, Walji M, Rindal DB, Worley D, White J, Kalenderian E. The Nature of Adverse Events in Dentistry. J Patient Saf 2024:01209203-990000000-00245. [PMID: 39078664 DOI: 10.1097/pts.0000000000001255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
OBJECTIVES Learning from clinical data on the subject of safety with regards to patient care in dentistry is still largely in its infancy. Current evidence does not provide epidemiological estimates on adverse events (AEs) associated with dental care. The goal of the dental practice study was to quantify and describe the nature and severity of harm experienced in association with dental care, and to assess for disparities in the prevalence of AEs. METHODS Through a multistaged sampling procedure, we conducted in-depth retrospective review of patients' dental and medical records. RESULTS We discovered an AE proportion of 1.4% (95% CI, 1.1% to 1.8). At least two-thirds of the detected AEs were preventable. Eight percent of patients who experienced harm due to a dental treatment presented only to their physician and not to the dentist where they originally received care. CONCLUSIONS Although most studies of AEs have focused on hospital settings, our results show that they also occur in ambulatory care settings. Extrapolating our data, annually, at least 3.3 million Americans experience harm in relation to outpatient dental care, of which over 2 million may be associated with an error. PRACTICAL IMPLICATIONS Measurement is foundational in enabling learning and improvement. A critical first step in preventing errors and iatrogenic harm in dentistry is to understand how often these safety incidents occur, what type of incidents occur, and what the consequences are in terms of patient suffering, and cost to the healthcare system.
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Affiliation(s)
- Bunmi Tokede
- From the Department of Diagnostic and Biomedical Sciences, The University of Texas at Houston Health Science Center, Houston, Texas
| | - Alfa Yansane
- †Preventative and Restorative Dental Sciences, University of California, San Francisco/ UCSF School of Dentistry, San Francisco, California
| | - Muhammad Walji
- Diagnostic and Biomedical Sciences Department, University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas
| | - D Brad Rindal
- HealthPartners Institute, Associate Dental Director for Research, HealthPartners Dental Group, Bloomington, Minnesota
| | - Donald Worley
- Quality and Operations Consultant, Dental, HealthPartners Dental Group
| | - Joel White
- Professor, Preventative and Restorative Dental Sciences, University of California, San Francisco/ UCSF School of Dentistry, San Francisco, California
| | - Elsbeth Kalenderian
- Professor and Dean, Marquette University School of Dentistry, Milwaukee, Wisconsin
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Keil O, Wegener JB, Schiller B, Vetter M, Flentje M, Eismann H. Implementation and adoption of SOAP-M and SBAR at a German anesthesiology department - a single-center survey study. BMC Anesthesiol 2024; 24:255. [PMID: 39060969 PMCID: PMC11282676 DOI: 10.1186/s12871-024-02650-2] [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: 10/12/2023] [Accepted: 07/22/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Checklists are a common tool used in order to mitigate risks caused by human factors and can facilitate the safe induction of anesthesia as well as handovers. SBAR (Situation, Background, Assessment, Recommendation) is a checklist recommended by the WHO and DGAI for handovers, while SOAP-M (Suction, Oxygen, Airway, Pharmaceuticals, Monitoring) is a checklist for the induction of anesthesia. This study investigates the implementation and adoption of these two checklists. METHODS We conducted a single-center online survey one year after the implementation of SOAP-M and SBAR at a university hospital's anesthesiology department, using scales from three validated questionnaires to assess safety attitudes as well as the behavior of staff and the perceived usefulness of the checklists. RESULTS Staff with a high score in general attitude towards patient safety, as determined by the safety attitudes questionnaire, considered both checklists useful additions to their work environment. Nurses and physicians (p = 0.102) as well as groups divided according to work experience (p = 0.077) showed no significant differences in using SOAP-M and SBAR. Perceived usefulness was significantly higher (p < 0.001) among users of the checklists, and the same goes for positive reinforcement (p < 0.001), social cues (p = 0.0215) and goal cues (p = 0.0252). CONCLUSION SOAP-M and SBAR are perceived as useful checklists for patient handovers and anesthesia induction by tertiary referral hospital's employees with high score in general safety attitude and were therefore commonly used one year after their introduction. No significant difference in checklist adoption between occupations as well as groups divided according to work experience could be found. Perceived usefulness is significantly higher among users of the checklist, who feel using the checklists provides more support.
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Affiliation(s)
- Oliver Keil
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl- Neuberg-Str. 1, 30625, Hannover, Germany
| | - Justus Bernd Wegener
- Business School, Middlesex University London, The Burroughs, London, NW4 4BT, UK
- Department of Cardiology and Pulmonology, University Medical Center Goettingen, Robert- Koch-Straße 40, 37075, Goettingen, Germany
| | - Benjamin Schiller
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl- Neuberg-Str. 1, 30625, Hannover, Germany
| | - Mathäus Vetter
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl- Neuberg-Str. 1, 30625, Hannover, Germany
| | - Markus Flentje
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl- Neuberg-Str. 1, 30625, Hannover, Germany
| | - Hendrik Eismann
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl- Neuberg-Str. 1, 30625, Hannover, Germany.
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Chance EA, Florence D, Sardi Abdoul I. The effectiveness of checklists and error reporting systems in enhancing patient safety and reducing medical errors in hospital settings: A narrative review. Int J Nurs Sci 2024; 11:387-398. [PMID: 39156684 PMCID: PMC11329062 DOI: 10.1016/j.ijnss.2024.06.003] [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: 11/13/2023] [Revised: 05/10/2024] [Accepted: 06/06/2024] [Indexed: 08/20/2024] Open
Abstract
Objectives This narrative review aimed to explore the impact of checklists and error reporting systems on hospital patient safety and medical errors. Methods A systematic search of academic databases from 2013 to 2023 was conducted, and peer-reviewed studies meeting inclusion criteria were assessed for methodological rigor. The review highlights evidence supporting the efficacy of checklists in reducing medication errors, surgical complications, and other adverse events. Error reporting systems foster transparency, encouraging professionals to report incidents and identify systemic vulnerabilities. Results Checklists and error reporting systems are interconnected. Interprofessional collaboration is emphasized in checklist implementation. In this review, limitations arise due to the different methodologies used in the articles and potential publication bias. In addition, language restrictions may exclude valuable non-English research. While positive impacts are evident, success depends on organizational culture and resources. Conclusions This review contributes to patient safety knowledge by examining the relevant literature, emphasizing the importance of interventions, and calling for further research into their effectiveness across diverse healthcare and cultural settings. Understanding these dynamics is crucial for healthcare providers to optimize patient safety outcomes.
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Villena-Salinas J, Sempere Alcocer MA, Gallego Peinado M. Risk management of radioiodine treatment in differentiated thyroid cancer. Rev Esp Med Nucl Imagen Mol 2024; 43:500029. [PMID: 39002946 DOI: 10.1016/j.remnie.2024.500029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 07/15/2024]
Abstract
INTRODUCTION Patient safety is paramount in providing quality healthcare and constitutes a global concern for healthcare systems. Radioiodine treatment to patients with well-differentiated thyroid cancer is not without risks. The aim of this study is to identify, evaluate and mitigate the risks associated with this procedure. MATERIALS AND METHODS A single-centre descriptive study was conducted in which risk management was carried out by establishing a risk map using FMEA methodology. RESULTS Based on the process map 6 sub-processes and 23 failure modes in the three phases of the treatment process were analysed. According to risk priority number (RPN), the sub-process with the highest risk was administrative management (RPN 82), followed by treatment per se and post-treatment imaging (both with RPN 70). An overall process RPN of 300 (156 pre-treatment, 74 treatment and 70 post-treatment) was obtained. Failures directly related to the patient pose a high risk. The implementation of verification systems, performing tasks earlier and providing quality medical information are the most relevant preventive measures to be implemented. CONCLUSIONS The application of the FMEA methodology in the risk management for radioiodine treatment is a valuable tool for improving the quality and safety of this process. The risk map has been able to identify failures at different stages, assess their causes and effects, prioritise the risks identified and implement preventive and corrective measures that can be monitored, ensuring the effectiveness of the actions taken.
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Affiliation(s)
- J Villena-Salinas
- Servicio de Medicina Nuclear, Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain.
| | - M A Sempere Alcocer
- Facultad de la Salud, Universidad Internacional de la Rioja, La Rioja, Spain; Servicio de Microbiología, Hospital Universitario Virgen de la Victoria, Málaga, Andalucía, Spain
| | - M Gallego Peinado
- Servicio de Medicina Nuclear, Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain
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Alkahf D, Alonazi W. Exploring the safety reporting culture among healthcare practitioners in Saudi hospitals: a comprehensive 2022 national study. BMC Health Serv Res 2024; 24:769. [PMID: 38943125 PMCID: PMC11214220 DOI: 10.1186/s12913-024-11160-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/31/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND With the rise in medical errors, establishing a strong safety culture and an effective incident reporting system is crucial. As part of the Saudi National Health Transformation Vision of 2030, multiple projects have been initiated to periodically assess healthcare quality measures and ensure a commitment to continuous improvement. Among these is the Hospital Survey on Patient Safety Culture National Project (HSPSC), conducted regularly by the Saudi Patient Safety Center (SPSC). However, comprehensive tools for assessing reporting culture are lacking. Addressing this gap can enhance reporting, efficiency, and health safety. OBJECTIVE This paper aims to investigate the reporting practices among healthcare professionals (HCPs) in Saudi Arabian hospitals and examine the relationship between reporting culture domains and other variables such as hospital bed capabilities and HCPs' work positions. METHODS The study focuses on measuring the reporting culture-related items measures and employs secondary data analysis using information from the Hospital Survey on Patient Safety Culture conducted by the Saudi Center for Patient Safety in 2022, encompassing hospitals throughout Saudi Arabia. Data incorporated seven items in total: four items related to the Response to Error Domain, two related to the Reporting Patient Safety Events Domain, and one associated with the number of events reported in the past 12 months. RESULTS The sample for the analyzed data included 145,657 HCPs from 392 hospitals. The results showed that the average positive response rates for reporting culture-related items were between 50% and 70%. In addition, the research indicated that favorable response rates were relatively higher among managerial and quality/patient safety/risk management staff. In contrast, almost half had not reported any events in the preceding year, and a quarter reported only 1 or 2 events. Pearson correlation analysis demonstrates a strong negative correlation between bed capacity and reporting safety events, response to error, and number of events reported (r = -0.935, -0.920, and - 0.911, respectively; p < 0.05), while a strong positive correlation is observed between reporting safety events and response to error (r = 0.980; p < 0.01). CONCLUSIONS Almost 75% of the HCPs reported fewer safety events over the last 12 months, indicating an unexpectedly minimal recorded occurrence variance ranging from 0 to 2 incidents.
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Affiliation(s)
- Dyma Alkahf
- Health Administration Department, College of Business Administration, King Saud University , PO Box 71115, Riyadh, 11587, Saudi Arabia.
| | - Wadi Alonazi
- Health Administration Department, College of Business Administration, King Saud University , PO Box 71115, Riyadh, 11587, Saudi Arabia
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Hamdan M, Jaaffar AH, Khraisat O, Issa MR, Jarrar M. The Association of Transformational Leadership on Safety Practices Among Nurses: The Mediating Role of Patient Safety Culture. Risk Manag Healthc Policy 2024; 17:1687-1700. [PMID: 38946841 PMCID: PMC11214760 DOI: 10.2147/rmhp.s458505] [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: 03/11/2024] [Accepted: 06/02/2024] [Indexed: 07/02/2024] Open
Abstract
Background To ensure best possible patient outcomes, patient safety is a major component of healthcare delivery system that needs to be prioritized. Safety practices among nurses are essential to maintain patient safety, especially the practices of medication administration, handover, patient falls and unplanned extubations prevention. Purpose To investigate the mediating effect of patient safety culture between the relationship of transformational leadership and safety practices among nurses. Methods The data in this cross-sectional study were gathered from a survey targeted clinical nurses using a random sampling technique. The study was conducted in a medical city in Saudi Arabia, and two hundred nurses were surveyed. The Multifactor Leadership, Hospital Survey on Patient Safety Culture, and Nursing Safety Practice questionnaires were used in the study. Results The results revealed significant positive associations between transformational leadership, patient safety culture, and nursing safety practices. Moreover, patient safety culture mediates the association between transformational leadership and safety practices among nurses. Conclusion Enhancing transformational leadership capabilities among nurse managers should be considered in order to improve nursing safety practices. Additionally, patient safety culture should be measured and improved periodically to ensure better nursing safety practices.
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Affiliation(s)
- Mahmoud Hamdan
- Quality Management and Patient Safety Administration, King Saud Medical City, Riyadh, Saudi Arabia
- College of Graduate Studies (COGS), Universiti Tenaga Nasional (UNITEN), Putrajaya Campus, Kajang, Selangor, 4300, Malaysia
| | - Amar Hisham Jaaffar
- Institute of Energy Policy and Research (Iepre), Universiti Tenaga Nasional (UNITEN), Putrajaya Campus, Kajang, Selangor, 4300, Malaysia
- College of Business Management and Accounting (COBA), Universiti Tenaga Nasional (UNITEN), Putrajaya Campus, Kajang, Selangor, 43000, Malaysia
| | - Omar Khraisat
- Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
| | - Marwan Rasmi Issa
- Skills Development Training Center, King Saud Medical City, Riyadh, 12746, Saudi Arabia
| | - Mu’taman Jarrar
- Medical Education Department, King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
- Vice Deanship for Development and Community Partnership, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Gardim L, dos Santos FR, Dias BM, Fuentes LBEH, Silveira RCDCP, Bernardes A. Lean and/or Six Sigma for process optimization in the perioperative period: an integrative review. Rev Bras Enferm 2024; 77:e20230431. [PMID: 38896715 PMCID: PMC11178310 DOI: 10.1590/0034-7167-2023-0431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/09/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE To analyze the evidence on the influence of Lean and/or Six Sigma for process optimization in the perioperative period. METHODS Integrative review carried out in the MEDLINE (PubMed), Web of Science, EMBASE, CINAHL, Scopus and LILACS databases on the use of Lean and/or Six Sigma to optimize perioperative processes. The studies included were analyzed in three thematic categories: flow of surgical patients, work process and length of stay. RESULTS The final sample consisted of ten studies, which covered all operative periods. Lean and/or Six Sigma make a significant contribution to optimizing perioperative processes. FINAL CONSIDERATIONS Lean and/or Six Sigma optimize perioperative processes to maximize the achievement of system stability indicators, making it possible to identify potential problems in order to recognize them and propose solutions that can enable the institution of patient-centered care.
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Affiliation(s)
- Lucas Gardim
- Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil
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Abstract
BACKGROUND Frontline nurses who care for patients with COVID-19 work in stressful environments, and many inevitably struggle with unanticipated ethical issues. Little is known about the unique, ethically sensitive issues that nurses faced when caring for patients with COVID-19. AIM To better understand how frontline nurses who care for patients with COVID-19 experience ethical issues towards others and themselves. METHODS Systematic review of qualitative evidence carried out according to the Preferred Reporting Items for Systematic reviews and Meta-analyses on ethical literature (PRISMA-Ethics). The electronic databases PubMed, Embase, Cinahl, Web of Science, Philosopher's Index, and Scopus were queried to identify candidate articles. Articles appearing from March 1, 2020 to December 31, 2022 were considered if they met the following inclusion criteria: (1) Published qualitative and mixed method studies and (2) ethical issues experienced by nurses caring for patients with COVID-19. We appraised the quality of included studies, and data analysis was guided by QUAGOL principles. FINDINGS Twenty-six studies meeting our inclusion criteria for how nurses experience ethical issues were characterised by two key themes: (1) the moral character of nurses as a willingness to respond to the vulnerability of human beings and (2) ethical issues nurses acted as barriers sometimes, impeding them from responding to requests of vulnerable human beings for dignified care. CONCLUSION Our review provides a deeper understanding of nurses' experiences of ethically sensitive issues, while also highlighting the critical need for adjustments to be made at organisational and societal levels. Ethical issues that emerged in situations where organisational and situational constraints impeded nurses' ethical responses to patients' appeals suggests that early practical support should be made available to resolve ethical issues recognised by nurses. Such support contributes to protecting and promoting not only the dignity of patients with COVID-19 but also of fellow humans in need during crisis.
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Tenza IS, Blignaut AJ, Ellis SM, Coetzee SK. Nurse perceptions of practice environment, quality of care and patient safety across four hospital levels within the public health sector of South Africa. BMC Nurs 2024; 23:324. [PMID: 38741078 DOI: 10.1186/s12912-024-01992-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/06/2024] [Indexed: 05/16/2024] Open
Abstract
Improving the practice environment, quality of care and patient safety are global health priorities. In South Africa, quality of care and patient safety are among the top goals of the National Department of Health; nevertheless, empirical data regarding the condition of the nursing practice environment, quality of care and patient safety in public hospitals is lacking.AimThis study examined nurses' perceptions of the practice environment, quality of care and patient safety across four hospital levels (central, tertiary, provincial and district) within the public health sector of South Africa.MethodsThis was a cross-sectional survey design. We used multi-phase sampling to recruit all categories of nursing staff from central (n = 408), tertiary (n = 254), provincial (n = 401) and district (n = 244 [large n = 81; medium n = 83 and small n = 80]) public hospitals in all nine provinces of South Africa. After ethical approval, a self-reported questionnaire with subscales on the practice environment, quality of care and patient safety was administered. Data was collected from April 2021 to June 2022, with a response rate of 43.1%. ANOVA type Hierarchical Linear Modelling (HLM) was used to present the differences in nurses' perceptions across four hospital levels.ResultsNurses rated the overall practice environment as poor (M = 2.46; SD = 0.65), especially with regard to the subscales of nurse participation in hospital affairs (M = 2.22; SD = 0.76), staffing and resource adequacy (M = 2.23; SD = 0.80), and nurse leadership, management, and support of nurses (M = 2.39; SD = 0.81). One-fifth (19.59%; n = 248) of nurses rated the overall grade of patient safety in their units as poor or failing, and more than one third (38.45%; n = 486) reported that the quality of care delivered to patient was fair or poor. Statistical and practical significant results indicated that central hospitals most often presented more positive perceptions of the practice environment, quality of care and patient safety, while small district hospitals often presented the most negative. The practice environment was most highly correlated with quality of care and patient safety outcomes.ConclusionThere is a need to strengthen compliance with existing policies that enhance quality of care and patient safety. This includes the need to create positive practice environments in all public hospitals, but with an increased focus on smaller hospital settings.
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Affiliation(s)
- Immaculate Sabelile Tenza
- School of Nursing Science, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
| | - Alwiena J Blignaut
- School of Nursing Science, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Suria M Ellis
- Department of Statistical Consultation, Faculty of Humanities, North-West University, Potchefstroom, South Africa
| | - Siedine K Coetzee
- School of Nursing Science, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Park J, Jeon H, Choi EK. Digital health intervention on patient safety for children and parents: A scoping review. J Adv Nurs 2024; 80:1750-1760. [PMID: 37950382 DOI: 10.1111/jan.15954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/19/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
AIM To explore digital health interventions on patient safety for children and their parents. DESIGN A scoping review. METHODS The PCC 'Participants, Concepts, and Contexts' guided the selection of studies that focused on children under 19 years of age or their parents, patient safety interventions for children, and digital health technology for patient safety interventions. This study was conducted using the Arksey and O'Malley framework's five steps. We reported the review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. DATA SOURCES PubMed, CINAHL, Embase, Web of Science, and Cochrane were searched for articles published up to November 2022. RESULTS A total of 13 articles were included and categorized according to the following criteria to describe the results: intervention characteristics, type of digital technology, and outcome characteristics. Regarding intervention characteristics, we identified two categories, prevention and risk management. Additionally, we identified four types of digital technology, mobile applications, web-based technologies, computer kiosks and electronic health records. Finally, in studies focussing on child safety, parental safety behaviours were used to assess injury risk or detect changes related to prevention. CONCLUSION Patient safety interventions provided through appropriate digital technologies should be developed to enhance continuum of care for children from hospitalization to home after discharge. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Digital health interventions can bolster the role of healthcare providers in patient safety in and out of hospitals, thus improving children's safety and quality of care. IMPACT What problem did the study address? Although the various advantages of digital health technology have been demonstrated, the potential role of digital technology in patient safety interventions for children has not been explored. What were the main finding? Preventive patient safety interventions and risk management for children have been developed. Where and on whom will the research have an impact? Digital health interventions on patient safety can improve children's safety and quality of care by promoting non-face-to-face engagement of children and parents after discharge and expanding healthcare providers' roles. TRIAL AND PROTOCOL REGISTRATION Registered on the Open Science Framework (https://osf.io/dkvst). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jisu Park
- Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Heejung Jeon
- Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Eun Kyoung Choi
- College of Nursing, Yonsei University, Seoul, South Korea
- Mo-Im Kim Nursing Research Institute College of Nursing, Yonsei University, Seoul, South Korea
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Fassi CF, Mourajid Y, Azilagbetor DM, Sabri A, Chahboune M, Hilali A. Assessment of patient safety culture in Moroccan primary health care: a multicentric study. BMC Nurs 2024; 23:189. [PMID: 38515099 PMCID: PMC10956179 DOI: 10.1186/s12912-024-01864-6] [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: 09/29/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
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.
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Affiliation(s)
- Chaima Fihri Fassi
- Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Hassan First University of Settat, Settat, Morocco.
| | - Yasmine Mourajid
- Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Hassan First University of Settat, Settat, Morocco
| | | | - Asma Sabri
- Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Hassan First University of Settat, Settat, Morocco
| | - Mohamed Chahboune
- Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Hassan First University of Settat, Settat, Morocco
| | - Abderraouf Hilali
- Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Hassan First University of Settat, Settat, Morocco
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Vikan M, Deilkås EC, Valeberg BT, Bjørnnes AK, Husby VS, Haugen AS, Danielsen SO. The anatomy of safe surgical teams: an interview-based qualitative study among members of surgical teams at tertiary referral hospitals in Norway. Patient Saf Surg 2024; 18:7. [PMID: 38374077 PMCID: PMC10877820 DOI: 10.1186/s13037-024-00389-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/26/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND In spite of the global implementation of surgical safety checklists to improve patient safety, patients undergoing surgical procedures remain vulnerable to a high risk of potentially preventable complications and adverse outcomes. The present study was designed to explore the surgical teams' perceptions of patient safety culture, capture their perceptions of the risk for adverse events, and identify themes of interest for quality improvement within the surgical department. METHODS This qualitative study had an explorative design with an abductive approach. Individual semi-structured in-depth interviews were conducted between 10/01/23 and 11/05/23. The participants were members of surgical teams (n = 17), general and orthopedic surgeons (n = 5), anesthesiologists (n = 4), nurse anesthetists (n = 4) and operating room nurses (n = 4). Middle managers recruited purposively from general and orthopedic surgical teams in two tertiary hospitals in Norway, aiming for a maximum variation due to gender, age, and years within the specialty. The data material was analyzed following Braun and Clarke's method for reflexive thematic analysis to generate patterns of meaning and develop themes and subthemes. RESULTS The analysis process resulted in three themes describing the participants' perceptions of patient safety culture in the surgical context: (1) individual accountability as a safety net, (2) psychological safety as a catalyst for well-being and safe performance in the operating room, and (3) the importance of proactive structures and participation in organizational learning. CONCLUSIONS This study provided an empirical insight into the culture of patient safety in the surgical context. The study highlighted the importance of supporting the individuals' competence, building psychological safety in the surgical team, and creating structures and culture promoting a learning organization. Quality improvement projects, including interventions based on these results, may increase patient safety culture and reduce the frequency of adverse events in the surgical context.
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Affiliation(s)
- Magnhild Vikan
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, Oslo, 0130, Norway.
| | - Ellen Ct Deilkås
- Department of Health Services Research, Akershus University Hospital, Lørenskog, Norway
| | - Berit T Valeberg
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, Oslo, 0130, Norway
| | - Ann K Bjørnnes
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, Oslo, 0130, Norway
| | - Vigdis S Husby
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, Oslo, 0130, Norway
- Department of Orthopedic Surgery, Trondheim University Hospital, Trondheim, Norway
- Department of Health Sciences Aalesund, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Aalesund, Norway
| | - Arvid S Haugen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, Oslo, 0130, Norway
- Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
| | - Stein O Danielsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, Oslo, 0130, Norway
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Labrague LJ. Emergency room nurses' caring ability and its relationship with patient safety outcomes: A cross-sectional study. Int Emerg Nurs 2024; 72:101389. [PMID: 38154194 DOI: 10.1016/j.ienj.2023.101389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/29/2023] [Accepted: 11/16/2023] [Indexed: 12/30/2023]
Abstract
INTRODUCTION Nurse caring ability plays a crucial role in providing quality care and ensuring patient safety. However, further research is warranted to understand the specific impact of caring ability on patient safety in the emergency department. AIM This study has two-fold purposes: (a) to examine the association between nurses' demographic characteristics and their perceptions of their caring ability, and (b) to explore the relationship between nurses' caring ability and nursing care quality, as well as its impact on adverse patient events and missed care. METHODS This cross-sectional study included a convenience sample of emergency room nurses working in select hospitals in the Philippines. Descriptive statistics and regression analyses were performed to analyze the data. RESULTS A total of 164 out of the 200 emergency nurses invited responded to the survey. The mean score for the caring ability inventory was 67.89 out of 80. Nurses' demographic characteristics, including job status (working part-time) and hospital size (working in small and medium-sized hospitals), were associated with higher levels of caring ability. Higher levels of nurses' caring ability were associated with better nursing care quality (β = 0.259, p <.001), a reduction in adverse events (β = -0.169, p <.05), and a decrease in instances of missed care (β = -0.158, p <.01). CONCLUSION This study emphasizes the significance of nurses' characteristics in influencing nurse caring abilities. Additionally, the results underscore the importance of nurse caring ability in the emergency department and its association with nursing care quality and patient safety outcomes. Organizational strategies directed toward promoting and enhancing nurse caring ability in the emergency department can have positive implications for nursing practice, including improved nursing care quality, reduced adverse events, and decreased instances of missed care.
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Bazzi M, Afram SS, Ndipen IM, Kåreholt I, Bjällmark A. Factors affecting radiographers' use of dose-reduction measures. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:011506. [PMID: 38232402 DOI: 10.1088/1361-6498/ad1fde] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/17/2024] [Indexed: 01/19/2024]
Abstract
This study investigates radiographers' views on implementing dose-reduction measures, with a focus on verifying patient identity and pregnancy status, practising gonad shielding in men and using compression. An electronic questionnaire was distributed to radiographers working in general radiography and/or computed tomography. The questionnaire was based on factors from a framework for analysing risk and safety in clinical medicine. Ordered logistic regressions were used to analyse associations among factors and use of dose-reduction measures. In total, 466 questionnaires were distributed and 170 radiographers (36%) completed them. Clear instructions and routines, support from colleagues, knowledge and experience, a strong safety culture, managerial support and access to proper equipment influence the likelihood of using dose-reduction measures. The strongest associations were found between support from colleagues and verifying pregnancy status (OR = 5.65,P= 0.026), safety culture and use of gonad shielding (OR = 2.36,P= 0.042), and having enough time and use of compression (OR = 2.11,P= 0.003). A strong safety culture and a supportive work environment appears to be essential for the use of dose-reduction measures, and education, training and stress management can improve utilisation of dose-reduction measures.
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Affiliation(s)
- May Bazzi
- Department of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | | | | | - Ingemar Kåreholt
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Anna Bjällmark
- Department of Clinical Diagnostics, School of Health and Welfare, Jönköping University, Gjuterigatan 5, Jönköping SE-553 18, Sweden
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18
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Zhou M, Zhou H, Zhang X, Jin X, Su X, Bai Y, Wei W, Zhang Y, Ma F. A qualitative study on patients' and health care professionals' perspectives regarding care delivered during CIED operation. BMC Health Serv Res 2024; 24:73. [PMID: 38225638 PMCID: PMC10789075 DOI: 10.1186/s12913-024-10546-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Cardiac implantable electronic devices (CIEDs) has proven to be an invaluable tool in the practice of cardiology. Patients who have undergone CIED surgery with local anesthesia may result in fear, insecurity and suffering. Some studies have put efforts on ways to improve intraoperative experience of patients with local anesthesia, but researches concerning experiences of CIED patients during surgery is in its infancy. METHODS Based on semi-structured and in-depth interviews, a qualitative design was conducted in a tertiary general hospital in China from May 2022 to July 2023.Purposeful sampling of 17 patients received CIED surgery and 20 medical staff were interviewed. Thematic analysis with an inductive approach was used to identify dominant themes. RESULTS Four themes emerged from the data: (1) Safety and success is priority; (2) Humanistic Caring is a must yet be lacking; (3) Paradox of surgery information given; (4) Ways to improve surgery experiences in the operation. CONCLUSIONS Intraoperative care is significant for CIED surgery. To improve care experience during surgery, healthcare professionals should pay attention to patients' safety and the factors that affecting humanistic caring in clinical practice. In addition, information support should consider information-seeking styles and personal needs. Besides, the four approaches presented in this study are effective to improve the intraoperative care experience.
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Affiliation(s)
- Min Zhou
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
- School of Nursing, Kunming Medical University, Kunming, China
| | - Huilin Zhou
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
| | - Xiong Zhang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
| | - Xiaorong Jin
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
| | - Xu Su
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
| | - Yangjuan Bai
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wei Wei
- Digestive Surgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yimei Zhang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
| | - Fang Ma
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China.
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Bartoníčková D, Kohanová D, Žiaková K, Młynarska A, Kolarczyk E, Steven A. Nursing students' evaluation of patient safety culture in three central European countries: a cross-sectional study. Int J Nurs Educ Scholarsh 2024; 21:ijnes-2023-0084. [PMID: 38906531 DOI: 10.1515/ijnes-2023-0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/04/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES This cross-sectional study aimed to investigate and compare the perceptions of nursing students regarding patient safety culture (PSC) during the COVID-19 pandemic in three Central European countries. METHODS Data were collected from 624 nursing students between April and September 2021 using the Hospital Survey on Patient Safety Culture. RESULTS The evaluation of the PSC dimensions did not reach the expected level of 75 %. Significant associations were found between the perception of the dimensions of the individual PSC and age, student status, study year, and clinical placement. The overall patient safety grade, the number of events reported, and the number of events reported by nursing students were significantly predicted by several dimensions of the PSC (p<0.05). CONCLUSIONS The evaluation of patient safety culture by nursing students offers a unique perspective. Students come with 'fresh eyes' and provide different perspectives that can provide healthcare leaders with a practical opportunity to identify blind spots, review and improve safety protocols, and foster a more inclusive culture that prioritizes patient safety.
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Affiliation(s)
- Daniela Bartoníčková
- 112842 Jessenius Faculty of Medicine, Comenius University in Bratislava , Martin, Slovakia
| | - Dominika Kohanová
- 157903 Faculty of Social Sciences and Health Care, Constantine the Philosopher University , Nitra, Slovakia
| | - Katarína Žiaková
- 112842 Jessenius Faculty of Medicine, Comenius University in Bratislava , Martin, Slovakia
| | - Agnieszka Młynarska
- Faculty of Health Sciences, Medical University of Silesia, Katowice , Poland
| | - Ewelina Kolarczyk
- Faculty of Health Sciences, Medical University of Silesia, Katowice , Poland
| | - Alison Steven
- Department of Nursing, Midwifery, and Health, 373117 Faculty of Health and Life Sciences, Northumbria University , Newcastle upon Tyne, UK
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Kim SH, Moon KJ. Exploring influential factors on patient safety culture in delirium nursing care within long-term care facilities: a cross-sectional survey. BMC Health Serv Res 2023; 23:1411. [PMID: 38098037 PMCID: PMC10722711 DOI: 10.1186/s12913-023-10452-4] [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: 09/15/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Elderly residents with physical and cognitive impairments in long-term care facilities are vulnerable to safety risks. PURPOSE This study investigated factors that influence patient safety cultures in delirium nursing care in long-term care facilities. METHODS A cross-sectional survey was conducted among 214 nurses working in 12 long-term care facilities using a structured questionnaire from February 15, 2022, to March 14, 2022. Data analysis was performed using Pearson's correlation coefficients and hierarchical analysis with SPSS/WIN 25.0 software. RESULTS Significant factors associated with patient safety culture were identified. Organizational factors included the availability of delirium care manuals, nursing education and experience in delirium care, and the perceived necessity of delirium education. Individual factors included nurse-to-patient ratios, and nurses marital status. CONCLUSION To foster a strong patient safety culture, attention should be given to the availability of delirium care resources, the promotion of specialized and ongoing education and experience, and adequate staffing levels.
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Affiliation(s)
- Se Hee Kim
- Keimyung University, 1095 Dalgubeol-daero, Dalse-gu, 42601, Daegu, South Korea
| | - Kyoung Ja Moon
- Keimyung University, 1095 Dalgubeol-daero, Dalse-gu, 42601, Daegu, South Korea.
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Mistri IU, Badge A, Shahu S. Enhancing Patient Safety Culture in Hospitals. Cureus 2023; 15:e51159. [PMID: 38283419 PMCID: PMC10811440 DOI: 10.7759/cureus.51159] [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: 10/11/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Patient safety has become a top priority for healthcare organizations. A better patient safety environment is associated with a lower probability of significant complications. Training programmers is critical to promoting patient safety and minimizing misunderstandings. The quality, performance, and productivity of the healthcare industry can be dramatically improved by changing the patient safety atmosphere operating within the hospital sector. Hospitals can significantly reduce medical errors and adverse events by implementing the program and training programmers to prioritize patient safety. This will improve patient outcomes and increase efficiency and effectiveness. Creating a patient safety culture within hospitals will contribute to a higher standard of care and improved overall performance in the healthcare industry. Hospitals can identify systemic problems and implement proactive measures to prevent future incidents by creating an environment in which healthcare professionals feel comfortable reporting errors. A patient safety culture encourages collaboration and open communication among healthcare teams leading to more effective and coordinated care.
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Affiliation(s)
- Isha U Mistri
- Hospital Administration, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Nagpur, IND
| | - Ankit Badge
- Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Nagpur, IND
| | - Shivani Shahu
- Hospital Administration, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Nagpur, IND
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Watari T, Kurihara M, Nishizaki Y, Tokuda Y, Nagao Y. Safety culture survey among medical residents in Japan: a nationwide cross-sectional study. BMJ Open Qual 2023; 12:e002419. [PMID: 37797961 PMCID: PMC10551985 DOI: 10.1136/bmjoq-2023-002419] [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: 05/16/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
PURPOSE This study aimed to examine safety culture among Japanese medical residents through a comparative analysis of university and community hospitals and an investigation of the factors related to safety culture. METHOD This nationwide cross-sectional study used a survey to assess first and second-year medical residents' perception of safety culture. We adapted nine key items from the Safety Awareness Questionnaire to the Japanese training environment and healthcare system. Additionally, we explored specific factors relevant to safety culture, such as gender, year of graduation, age, number of emergency room duties per month, average number of admissions per day, incident experience, incident reporting experience, barriers to incident reporting and safety culture. We analysed the data using descriptive statistics and multivariate logistic regression analysis. RESULTS We included 5289 residents (88.6%) from community training hospitals and 679 residents (11.4%) from university hospitals. A comparative analysis of safety culture between the two groups on nine representative questions revealed that the percentage of residents who reported a positive atmosphere at their institution was significantly lower at university hospitals (81.7%) than at community hospitals (87.8%) (p<0.001). The other items were also significantly lower for university hospital residents. After adjusting for multivariate logistic analysis, university hospital training remained significantly and negatively associated with all nine safety culture items. Furthermore, we also found that university hospital residents perceived a significantly lower level of safety culture than community hospital residents. IMPLICATIONS Further research and discussion on medical professionals' perception of safety culture in their institutions as well as other healthcare professionals' experiences are necessary to identify possible explanations for our findings and develop strategies for improvement.
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Affiliation(s)
- Takashi Watari
- General Medicine Center, Shimane University Hospital, Izumo, Shimane, Japan
- Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | | | - Yasuharu Tokuda
- Muribushi Okinawa Project for Teaching Hospitals, Okinawa, Japan
| | - Yoshimasa Nagao
- Department of Patient Safety, Nagoya University Hospital, Nagoya, Japan
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Kaya S, Banaz Goncuoglu M, Mete B, Asilkan Z, Mete AH, Akturan S, Tuncer N, Yukselir Alasirt F, Toka O, Gunes T, Gumus R. Patient Safety Culture: Effects on Errors, Incident Reporting, and Patient Safety Grade. J Patient Saf 2023; 19:439-446. [PMID: 37729641 DOI: 10.1097/pts.0000000000001152] [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: 09/22/2023]
Abstract
OBJECTIVES This study mainly examines the effects of patient safety culture dimensions on 4 outcomes (self-reported errors, witnessing errors, incident reporting, and patient safety grade). METHODS The data were collected using the Turkish version of the Safety Attitudes Questionnaire, which consists of 6 dimensions (teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions). Of 1679 personnel working in 6 hospitals in Ankara, 860 were randomly selected. The data were analyzed using descriptive statistics, the Spearman correlation coefficient, and binary logistic regression analyses. RESULTS The response rate was 62.7%. When the overall patient safety culture score increased by 1 point; the probability of witnessing an error was 2 times lower (P < 0.001), the probability of incident reporting was 4.22 times higher (P < 0.001), and the probability of assessing the patient safety grade as excellent was 29.86 times higher (P < 0.001). The teamwork climate was negatively related to making errors and witnessing errors (P < 0.001). The safety climate and working conditions were positively related to incident reporting and patient safety grade (P < 0.001). Job satisfaction was negatively related to incident reporting (P < 0.001). Perceptions of management were positively related to making errors and patient safety grade (P < 0.001). CONCLUSIONS The patient safety culture scores were positively correlated with incident reporting and patient safety grade but negatively correlated with the occurrence of errors. Each dimension of the patient safety culture, except stress recognition, affected different outcomes. Therefore, managers should focus on different dimensions of patient safety culture to improve different outcomes.
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Affiliation(s)
- Sıdıka Kaya
- From the Department of Health Management, Faculty of Economics and Administrative Sciences, Hacettepe University, Ankara
| | | | - Buse Mete
- Department of Health Management, Faculty of Health Sciences, Sakarya University of Applied Sciences, Sakarya
| | - Zeliha Asilkan
- Medical Documentation And Secretarial Program, Department of Medical Services and Techniques, Vocational School of Health Services, Izmir University of Economics, Izmir
| | - Anı Hande Mete
- Department of Health Management, Faculty of Health Sciences, Istanbul University - Cerrahpasa, Istanbul
| | - Saadet Akturan
- Department of General Surgery, Yıldırım Beyazıt University Yenimahalle Training and Research Hospital, Ankara
| | - Nursel Tuncer
- Department of Health Management, Faculty of Health Sciences, Hitit University, Corum
| | - Fatma Yukselir Alasirt
- Department of Health Management, Faculty of Health Sciences, Kırklareli University, Kırklareli
| | - Onur Toka
- Department of Statistics, Faculty of Science, Hacettepe University
| | | | - Rana Gumus
- Oncology Hospital, Hacettepe University, Ankara, Turkey
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Alanazi FK, Lapkin S, Molloy L, Sim J. The impact of safety culture, quality of care, missed care and nurse staffing on patient falls: A multisource association study. J Clin Nurs 2023; 32:7260-7272. [PMID: 37309059 DOI: 10.1111/jocn.16792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/08/2023] [Accepted: 05/29/2023] [Indexed: 06/14/2023]
Abstract
AIMS To examine the association between nursing unit safety culture, quality of care, missed care and nurse staffing levels, and inpatient falls using two data sources: incidence of falls and nurses' perceptions of fall frequency in their units. The study explores the association between the two sources of patient falls and identifies if nurses' perceptions of patient fall frequency reflect the actual patient falls recorded in the incident management system. BACKGROUND Inpatient falls are associated with severe complications that result in extended hospitalisation and increased financial consequences for patients and healthcare services. DESIGN A multi-source cross-sectional study guided by the STROBE guidelines. METHODS A purposive sample of 33 nursing units (619 nurses) from five hospitals completed an online survey from August to November 2021. The survey measured safety culture, quality of care, missed care, nurse staffing levels and nurses' perceptions of patient fall frequency. In addition, secondary data on falls from participating units between 2018 and 2021 were also collected. Generalised linear models were fitted to examine the association between study variables. RESULTS Nursing units with strong safety climate and working conditions and lower missed care were associated with lower rates of falls using both data sources. Nurses' perceptions of the frequency of falls in their units were reflective of the actual incidence rate of falls, but the association was not statistically significant. CONCLUSION Nursing units with a strong safety climate and better collaborations between nurses and other professionals, including physicians and pharmacists, were associated with lower incidents of patient falls. RELEVANCE TO CLINICAL PRACTICE This study provided evidence for healthcare services and hospital managers to minimise patient falls. PATIENT OR PUBLIC CONTRIBUTION Patients who had experienced a fall, which was reported in the incident management system, from the included units in the five hospitals were part of this study.
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Affiliation(s)
| | - Samuel Lapkin
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
- Discipline of Nursing, Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - Luke Molloy
- Discipline of Nursing, Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
- World Health Organization Collaborating Centre for Nursing, Midwifery & Health Development, University of Technology Sydney, Ultimo, New South Wales, Australia
- School of Nursing & Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
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Chen L, Yang H, Cui S, Ye D. Impact of Target Management Card on Patient Safety in the Emergency Department: A Mixed Methods Study. Risk Manag Healthc Policy 2023; 16:1905-1914. [PMID: 37746044 PMCID: PMC10516123 DOI: 10.2147/rmhp.s427988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023] Open
Abstract
Purpose This study aimed to investigate the potential impact of the Target Management Card on patient safety in the emergency department. Patients and Methods A mixed method design was developed, combining a one-group pretest-posttest design with a qualitative study. Target Management Cards were formulated for 32 emergency nurse practitioners and focus group interviews were conducted after the intervention. Wilcoxon's signed rank test was used to compare pre-test and post-test scores. The interview data were subject to content analysis. Results After developing the Target Management Card, there were significant improvements in safety behaviors (Z = 4.709, p < 0.01) and perception of patient safety (Z = 4.257, p < 0.01) among emergency nurse practitioners. The nurses in the focus group interviews agreed that the Target Management Card could improve patient safety by warning and supervising nursing work in the emergency department, promoting a positive change in nurses' attitudes and behaviors toward patient safety. Conclusion Our study found that nurses and nursing managers jointly formulating Target Management Cards in emergency departments significantly enhances patient safety.
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Affiliation(s)
- Lixia Chen
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Heng Yang
- Department of Emergency, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Shaomei Cui
- Department of Emergency, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Danjuan Ye
- Department of Emergency, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
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Silverglow A, Wijk H, Lidén E, Johansson L. Patient safety culture in home care settings in Sweden: a cross-sectional survey among home care professionals. BMC Health Serv Res 2023; 23:998. [PMID: 37716938 PMCID: PMC10505324 DOI: 10.1186/s12913-023-10010-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/07/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND The connection between a weak patient safety culture and adverse patient events is well known, but although most long-term care is provided outside of hospitals, the focus of patient safety culture is most commonly on inpatient care. In Sweden, more than a third of people who receive care at home have been affected by adverse events, with the majority judged to be preventable. The aim of this study was to investigate the patient safety culture among care professionals working in care at home with older people. METHODS This cross-sectional study used a purposive sample of 66 municipal care workers, health care professionals, and rehabilitation staff from five municipal care units in two districts in western Sweden who provided care at home for older people and had been employed for at least six months. The participants completed the Hospital Survey on Patient Safety Culture (HSOPSC) self-report questionnaire, which assessed aspects of patient safety culture-norms, beliefs, and attitudes. Logistic regression analysis was used to test how the global ratings of Patient safety grade in the care units and Reporting of patient safety events were related to the dimensions of safety culture according to the staff's professions and years of work experience. RESULTS The most positively rated safety culture dimension was Teamwork within care units (82%), which indicates good cooperation with the closest co-workers. The least positively rated dimensions were Handoffs and transitions among care units (37%) and Management support (37%), which indicate weaknesses in the exchange of patient information across care units and limited support from top-level managers. The global rating of Patient safety grade was associated with Communication openness and Management support (p < 0.01 and p = 0.03, respectively). Staff with less work experience evaluated the Patient safety grade higher than those with more work experience. CONCLUSIONS This study suggests that improvements are needed in care transitions and in support from top-level managers and that awareness of patient safety should be improved in staff with less work experience. The results also highlight that an open communication climate within the care unit is important for patient safety.
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Affiliation(s)
- Anastasia Silverglow
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Helle Wijk
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
- The Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Gothenburg, Sweden
| | - Eva Lidén
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Johansson
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
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Fauziningtyas R, Chan CM, Pin TM, Dhamanti I, Smith GD. Psychometric properties of the Indonesian version of the nursing home survey on patient safety culture. Int J Older People Nurs 2023; 18:e12553. [PMID: 37334471 DOI: 10.1111/opn.12553] [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: 11/14/2022] [Revised: 03/29/2023] [Accepted: 05/07/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION The development of resident safety culture in nursing homes (NH) represents a major challenge for governments and NH owners, with a requirement for suitable tools to assess safety culture. Indonesia currently lacks suitable safety cultures scales for NH. OBJECTIVES To evaluate the psychometric properties of the translated Indonesian version of the Nursing Home Survey on Patient Safety Culture (NHSOPSC-INA). METHODS This study was a cross-sectional survey conducted using NHSOPSC-INA. A total of 258 participants from 20 NH in Indonesia were engaged. Participants included NH managers, caregivers, administrative staff, nurses and support staff with at least junior high school education. The SPSS 23.0 was used for descriptive data analysis and internal consistency (Cronbach's alpha) estimation. The AMOS (version 22) was used to perform confirmatory factor analysis (CFA) on the questionnaire's dimensional structure. RESULTS The NHSOPSC CFA test originally had 12 dimensions with 42 items and was modified to eight dimensions with 26 items in the Indonesian version. The deleted dimensions were 'Staffing' (4 items), 'Compliance with procedure' (3 items), 'Training and skills' (3 items), 'non-punitive response to mistakes' (4 items) and 'Organisational learning' (2 items). The subsequent analysis revealed an accepted model with 26 NHSOPSC-INA items (root mean square error of approximation = 0.091, comparative fit index = 0.815, Tucker-Lewis index = 0.793, CMIN = 798.488, df = 291, CMIN/Df = 2.74, GFI = 0.782, AGFI = 0.737, p < 0.0001) and a factor loading value of 0.538-0.981. Expert feedback confirmed the relevance of the instrument items (content validity index [CVI] = 0.942). CONCLUSION The modified NHSPOSC-INA model with eight dimensions (26 items) fits the data set in the context of Indonesian NH services. IMPLICATIONS FOR PRACTICE The NHSPOSC-INA is a valid and reliable instrument for assessing staff perceptions of NH resident safety culture in Indonesia. The questionnaire can now be used to evaluate interventions for resident safety in Indonesian NH.
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Affiliation(s)
- Rista Fauziningtyas
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Chong Mei Chan
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Tan Maw Pin
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Inge Dhamanti
- Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
- Center for Patient Safety Research, Universitas Airlangga, Surabaya, Indonesia
- La Trobe University, School of Psychology and Public Health, Melbourne, Australia
| | - Graeme D Smith
- Caritas Institute of Higher Education, Hong Kong, Hong Kong
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Wrześniewska-Wal I, Pinkas J, Ostrowski J, Jankowski M. Pharmacists' Perceptions of Physician-Pharmacist Collaboration-A 2022 Cross-Sectional Survey in Poland. Healthcare (Basel) 2023; 11:2444. [PMID: 37685477 PMCID: PMC10486938 DOI: 10.3390/healthcare11172444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
Patient-centered care requires close collaboration among multiple healthcare professionals, including physician-pharmacist collaboration (especially as a part of pharmaceutical care). This study aimed to assess pharmacists' perceptions of physician-pharmacist collaboration as well as to identify factors associated with the willingness to provide pharmaceutical care services in Poland. This questionnaire-based survey was carried out in 2022 among community pharmacists from one of the largest franchise chain pharmacy networks in Poland. Completed questionnaires were received from 635 community pharmacists (response rate of 47.9%). Almost all the pharmacists agreed with the statement that there is a need for physician-pharmacist collaboration (98.2%), and 94.8% declared that pharmacists can help physicians in patient care and pharmacotherapy. Most pharmacists (80%) believed that physicians were not aware of the competencies of pharmacists resulting from Polish law. Patient education (89.9%), detection of polypharmacy (88%), and detection of interactions between drugs and dietary supplements (85.7%) were the most common tasks in the field of pharmaceutical care that can be provided by a pharmacist. Females were more likely (p < 0.05) to declare the need for physician-pharmacist collaboration. Age and location of the pharmacy were the most important factors (p < 0.05) associated with pharmacists' attitudes toward physician-pharmacist collaboration.
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Affiliation(s)
- Iwona Wrześniewska-Wal
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
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Churruca K, Falkland E, Saba M, Ellis LA, Braithwaite J. An integrative review of research evaluating organisational culture in residential aged care facilities. BMC Health Serv Res 2023; 23:857. [PMID: 37580765 PMCID: PMC10424376 DOI: 10.1186/s12913-023-09857-y] [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: 03/06/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Evidence suggests that the culture of healthcare organisations, including residential aged care facilities (RACFs), is linked to the quality of care offered. The number of people living in RACFs has increased globally, and in turn, attention has been placed on care quality. This review aimed to identify how organisational culture is studied, sought to elucidate the results of previous studies, and aimed to establish what interventions are being used to improve organisational culture in RACFs. METHODS We employed an integrative review design to provide a comprehensive understanding of organisational culture. Five academic data bases were searched (Ovid Medline, Scopus, PsycInfo, CINAHL, Embase). Articles were included if they were empirical studies, published in peer reviewed journals in English, conducted in a RACF setting, and were focused on organisational culture/climate. RESULTS Ninety-two articles were included. Fifty-nine studies (64.1%) utilised a quantitative approach, while 24 (26.0%) were qualitative, and nine used mixed methods (9.8%). Twenty-two (23.9%) aimed to describe the culture within RACFs, while 65 (70.7%) attempted to understand the relationship between culture and other variables, demonstrating mixed and indeterminate associations. Only five (5.4%) evaluated an intervention. CONCLUSIONS This review highlights the heterogenous nature of this research area, whereby differences in how culture is demarcated, conceptualised, and operationalised, has likely contributed to mixed findings. Future research which is underpinned by a sound theoretical basis is needed to increase the availability of empirical evidence on which culture change interventions can be based.
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Affiliation(s)
- Kate Churruca
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW Australia
| | - Emma Falkland
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW Australia
| | - Maree Saba
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW Australia
| | - Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW Australia
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Bijok B, Jaulin F, Picard J, Michelet D, Fuzier R, Arzalier-Daret S, Basquin C, Blanié A, Chauveau L, Cros J, Delmas V, Dupanloup D, Gauss T, Hamada S, Le Guen Y, Lopes T, Robinson N, Vacher A, Valot C, Pasquier P, Blet A. Guidelines on human factors in critical situations 2023. Anaesth Crit Care Pain Med 2023; 42:101262. [PMID: 37290697 DOI: 10.1016/j.accpm.2023.101262] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To provide guidelines to define the place of human factors in the management of critical situations in anaesthesia and critical care. DESIGN A committee of nineteen experts from the SFAR and GFHS learned societies was set up. A policy of declaration of links of interest was applied and respected throughout the guideline-producing process. Likewise, the committee did not benefit from any funding from a company marketing a health product (drug or medical device). The committee followed the GRADE® method (Grading of Recommendations Assessment, Development and Evaluation) to assess the quality of the evidence on which the recommendations were based. METHODS We aimed to formulate recommendations according to the GRADE® methodology for four different fields: 1/ communication, 2/ organisation, 3/ working environment and 4/ training. Each question was formulated according to the PICO format (Patients, Intervention, Comparison, Outcome). The literature review and recommendations were formulated according to the GRADE® methodology. RESULTS The experts' synthesis work and application of the GRADE® method resulted in 21 recommendations. Since the GRADE® method could not be applied in its entirety to all the questions, the guidelines used the SFAR "Recommendations for Professional Practice" A means of secured communication (RPP) format and the recommendations were formulated as expert opinions. CONCLUSION Based on strong agreement between experts, we were able to produce 21 recommendations to guide human factors in critical situations.
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Affiliation(s)
- Benjamin Bijok
- Pôle Anesthésie-Réanimation, Bloc des Urgences/Déchocage, CHU de Lille, Lille, France; Pôle de l'Urgence, Bloc des Urgences/Déchocage, CHU de Lille, Lille, France.
| | - François Jaulin
- Président du Groupe Facteurs Humains en Santé, France; Directeur Général et Cofondateur Patient Safety Database, France; Directeur Général et Cofondateur Safe Team Academy, France.
| | - Julien Picard
- Pôle Anesthésie-Réanimation, Réanimation Chirurgicale Polyvalente - CHU Grenoble Alpes, Grenoble, France; Centre d'Evaluation et Simulation Alpes Recherche (CESAR) - ThEMAS, TIMC, UMR, CNRS 5525, Université Grenoble Alpes, Grenoble, France; Comité Analyse et Maîtrise du Risque (CAMR) de la Société Française d'Anesthésie Réanimation (SFAR), France
| | - Daphné Michelet
- Département d'Anesthésie-Réanimation du CHU de Reims, France; Laboratoire Cognition, Santé, Société - Université Reims-Champagne Ardenne, France
| | - Régis Fuzier
- Unité d'Anesthésiologie, Institut Claudius Regaud. IUCT-Oncopole de Toulouse, France
| | - Ségolène Arzalier-Daret
- Département d'Anesthésie-Réanimation, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000 Caen, France; Comité Vie Professionnelle-Santé au Travail (CVP-ST) de la Société Française d'Anesthésie-Réanimation (SFAR), France
| | - Cédric Basquin
- Département Anesthésie-Réanimation, CHU de Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France; CHP Saint-Grégoire, Groupe Vivalto-Santé, 6 Bd de la Boutière CS 56816, 35760 Saint-Grégoire, France
| | - Antonia Blanié
- Département d'Anesthésie-Réanimation Médecine Périopératoire, CHU Bicêtre, 78 Rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France; Laboratoire de Formation par la Simulation et l'Image en Médecine et en Santé (LabForSIMS) - Faculté de Médecine Paris Saclay - UR CIAMS - Université Paris Saclay, France
| | - Lucille Chauveau
- Service des Urgences, SMUR et EVASAN, Centre Hospitalier de la Polynésie Française, France; Maison des Sciences de l'Homme du Pacifique, C9FV+855, Puna'auia, Polynésie Française, France
| | - Jérôme Cros
- Service d'Anesthésie et Réanimation, Polyclinique de Limoges Site Emailleurs Colombier, 1 Rue Victor-Schoelcher, 87038 Limoges Cedex 1, France; Membre Co-Fondateur Groupe Facteurs Humains en Santé, France
| | - Véronique Delmas
- Service d'Accueil des Urgences, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72037 Le Mans, France; CAp'Sim, Centre d'Apprentissage par la Simulation, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72037 Le Mans, France
| | - Danièle Dupanloup
- IADE, Cadre de Bloc, CHU de Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, 54000 Nancy, France; Comité IADE de la Société Française d'Anesthésie Réanimation (SFAR), France
| | - Tobias Gauss
- Pôle Anesthésie-Réanimation, Bloc des Urgences/Déchocage, CHU Grenoble Alpes, Grenoble, France
| | - Sophie Hamada
- Université Paris Cité, APHP, Hôpital Européen Georges Pompidou, Service d'Anesthésie Réanimation, F-75015, Paris, France; CESP, INSERM U 10-18, Université Paris-Saclay, France
| | - Yann Le Guen
- Pôle Anesthésie-Réanimation, CHU Grenoble Alpes, Grenoble, France
| | - Thomas Lopes
- Service d'Anesthésie-Réanimation, Hôpital Privé de Versailles, 78000 Versailles, France
| | | | - Anthony Vacher
- Unité Recherche et Expertise Aéromédicales, Institut de Recherche Biomédicale des Armées, Brétigny Sur Orge, France
| | | | - Pierre Pasquier
- 1ère Chefferie du Service de Santé, Villacoublay, France; Département d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées Percy, Clamart, France; École du Val-de-Grâce, Paris, France
| | - Alice Blet
- Lyon University Hospital, Department of Anaesthesiology and Critical Care, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1052, Cancer Research Center of Lyon, Lyon, France
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Huang CH, Wu HH, Lee YC. A comparative study on patient safety culture among high-risk hospital staff in the context of the COVID-19 and non-COVID-19 pandemic: a cross-sectional study in Taiwan. Front Public Health 2023; 11:1200764. [PMID: 37575098 PMCID: PMC10415219 DOI: 10.3389/fpubh.2023.1200764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023] Open
Abstract
The study aimed to compare the evolution of patient safety culture perceived by high-risk hospital staff in the context of the COVID-19 pandemic and non-COVID-19 pandemic and to examine the variations in patient safety culture across demographic variables. The study found that the COVID-19 pandemic has significantly impacted patient safety culture in healthcare settings, with an increased focus on safety climate, job satisfaction, teamwork climate, stress recognition, and emotional exhaustion. Safety culture and work stress vary among medical professionals of different age groups. To reduce stress, workload should be minimized, work efficiency improved, and physical and mental health promoted. Strengthening safety culture can reduce work-related stress, improve job satisfaction, and increase dedication towards work. The study recommends interventions such as psychological and social support, along with emotional management training, to reduce emotional exhaustion. Healthcare institutions can set up psychological counseling hotlines or support groups to help medical professionals reduce stress and emotional burden.
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Affiliation(s)
- Chih-Hsuan Huang
- Business School, Hubei University of Economics, Wuhan, China
- Hubei Enterprise Culture Research Center, Hubei University of Economics, Wuhan, China
- Research Center of Hubei Logistics Development, Hubei University of Economics, Wuhan, China
| | - Hsin-Hung Wu
- Department of Business Administration, National Changhua University of Education, Changhua, Taiwan
- Department of M-Commerce and Multimedia Applications, Asia University, Taichung, Taiwan
- Faculty of Education, State University of Malang, Malang, East Java, Indonesia
| | - Yii-Ching Lee
- Department of Health Business Administration, Hung Kuang University, Taichung, Taiwan
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Moosavi S, Amerzadeh M, Azmal M, Kalhor R. The relationship between patient safety culture and adverse events in Iranian hospitals: a survey among 360 nurses. Patient Saf Surg 2023; 17:20. [PMID: 37496060 PMCID: PMC10373364 DOI: 10.1186/s13037-023-00369-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/10/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Adverse events have become a global problem and are an important indicator of patient safety. Patient safety culture is essential in efforts to reduce adverse events in the hospital. This study aimed to investigate the status of the patient safety culture, the frequency of adverse events, and the relationship between them in Qazvin's hospitals in Iran. METHODS The present study is a descriptive-analytical study conducted in six hospitals in Qazvin, Iran, in 2020. The study population was nurses working in Qazvin hospitals. We collected data via a patient safety culture questionnaire and an adverse event checklist. Three hundred sixty nurses completed questionnaires. Multiple logistic regression was used to investigate the relationship between variables. RESULTS The highest mean of patient safety culture was related to the organizational learning dimension (3.5, SD = .074) and feedback and communication about errors (3.4, SD = 0.82). The participants gave the lowest score to dimensions of exchanges and transfer of information (2.45,=0.86) and management support for patient safety (2.62,Sd = 0.65). Management's support for patient safety, general understanding of patient safety culture, teamwork within organizational units, communication and feedback on errors, staff issues, and information exchange and transfer were significant predictors of adverse events. CONCLUSION This study confirms patient safety culture as a predictor of adverse events. Healthcare managers should provide the basis for improving the patient safety culture and reducing adverse events through methods such as encouraging the reporting of adverse events and also holding training courses for nurses.
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Affiliation(s)
- Saeideh Moosavi
- Student Research Committee, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Azmal
- School of Medicine, Bushehr University of Medical Services, Bushehr, Iran
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
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Paladino J, Sanders JJ, Fromme EK, Block S, Jacobsen JC, Jackson VA, Ritchie CS, Mitchell S. Improving serious illness communication: a qualitative study of clinical culture. BMC Palliat Care 2023; 22:104. [PMID: 37481530 PMCID: PMC10362669 DOI: 10.1186/s12904-023-01229-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/17/2023] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVE Communication about patients' values, goals, and prognosis in serious illness (serious illness communication) is a cornerstone of person-centered care yet difficult to implement in practice. As part of Serious Illness Care Program implementation in five health systems, we studied the clinical culture-related factors that supported or impeded improvement in serious illness conversations. METHODS Qualitative analysis of semi-structured interviews of clinical leaders, implementation teams, and frontline champions. RESULTS We completed 30 interviews across palliative care, oncology, primary care, and hospital medicine. Participants identified four culture-related domains that influenced serious illness communication improvement: (1) clinical paradigms; (2) interprofessional empowerment; (3) perceived conversation impact; (4) practice norms. Changes in clinicians' beliefs, attitudes, and behaviors in these domains supported values and goals conversations, including: shifting paradigms about serious illness communication from 'end-of-life planning' to 'knowing and honoring what matters most to patients;' improvements in psychological safety that empowered advanced practice clinicians, nurses and social workers to take expanded roles; experiencing benefits of earlier values and goals conversations; shifting from avoidant norms to integration norms in which earlier serious illness discussions became part of routine processes. Culture-related inhibitors included: beliefs that conversations are about dying or withdrawing care; attitudes that serious illness communication is the physician's job; discomfort managing emotions; lack of reliable processes. CONCLUSIONS Aspects of clinical culture, such as paradigms about serious illness communication and inter-professional empowerment, are linked to successful adoption of serious illness communication. Further research is warranted to identify effective strategies to enhance clinical culture and drive clinician practice change.
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Affiliation(s)
- Joanna Paladino
- Massachusetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Ariadne Labs, Joint Innovation Center at Brigham & Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Mongan Institute Center for Aging and Serious Illness, Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, USA.
| | | | - Erik K Fromme
- Harvard Medical School, Boston, MA, USA
- Ariadne Labs, Joint Innovation Center at Brigham & Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Dana Farber Cancer Institute, Boston, MA, USA
| | - Susan Block
- Harvard Medical School, Boston, MA, USA
- Dana Farber Cancer Institute, Boston, MA, USA
| | - Juliet C Jacobsen
- Massachusetts General Hospital, Boston, MA, USA
- Lund University, Lund, Sweden
| | - Vicki A Jackson
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Christine S Ritchie
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Mongan Institute Center for Aging and Serious Illness, Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, USA
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Abuosi AA, Anaba EA, Attafuah PY, Tenza IS, Abor PA, Setordji A, Nketiah-Amponsah E. Comparing patient safety culture in primary, secondary and tertiary hospitals in Ghana. Ghana Med J 2023; 57:141-147. [PMID: 38504756 PMCID: PMC10846655 DOI: 10.4314/gmj.v57i2.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Objective This study compared patient safety culture among health professionals in tertiary, secondary and primary hospitals. Design We conducted a cross-sectional survey among thirteen primary, secondary and tertiary hospitals in Ghana. A structured questionnaire was administered to 1,656 health professionals. Data were analysed using descriptive statistics and One-Way Analysis of Variance (ANOVA). Setting This study was conducted in the Greater Accra, Bono and Upper East regions, representing the southern, middle and northern ecological zones, respectively. Participants Health professionals. Main outcome measures The primary outcome was patient safety culture. Results Five patient safety culture dimensions were rated moderate positive response, while five were rated high positive response. We found a statistically significant difference in patient safety culture across primary, secondary and tertiary hospitals (p < 0.05). For instance, the mean difference between tertiary and secondary hospitals was statistically significant (p < 0.05). Additionally, the mean difference between tertiary and primary hospitals was statistically significant (p < 0.05). There was also a significant difference in the means between secondary and primary hospitals (p < 0.05). Conclusion This study has demonstrated a variation in patient safety culture across Ghana's tertiary, secondary and primary hospitals. Therefore, healthcare managers and professionals should prioritise patient safety. Funding This work was supported by the University of Ghana [UGRF/13/MDG-001/2019-2020].
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Affiliation(s)
- Aaron A. Abuosi
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Ghana
| | - Emmanuel A. Anaba
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana
| | | | - Immaculate S. Tenza
- School of Nursing Science, Faculty of Health Science, North-West University, Potchefstroom Campus, South Africa
- South African Research Chairs Initiative (SARChI), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Patience A. Abor
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Ghana
| | - Adelaide Setordji
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Ghana
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Pfeiffer Y, Atkinson A, Maag J, Lane MA, Schwappach D, Marschall J. Are cross-sectional safety climate survey results in operating room staff associated with the surgical site infection rates in Swiss hospitals? BMJ Open 2023; 13:e066514. [PMID: 37076144 PMCID: PMC10124250 DOI: 10.1136/bmjopen-2022-066514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVES The aim of this study was to investigate the association between surgical site infections (SSIs), a major source of patient harm, and safety and teamwork climate. Prior research has been unclear regarding this relationship. DESIGN Based on the Swiss national SSI surveillance and a survey study assessing (a) safety climate and (b) teamwork climate, associations were analysed for three kinds of surgical procedures. SETTING AND PARTICIPANTS SSI surveillance data from 20 434 surgeries for hip and knee arthroplasty from 41 hospitals, 8321 for colorectal procedures from 28 hospitals and 4346 caesarean sections from 11 hospitals and survey responses from Swiss operating room personnel (N=2769) in 54 acute care hospitals. PRIMARY AND SECONDARY OUTCOMES The primary endpoint of the study was the 30-day (all types) or 1-year (knee/hip with implants) National Healthcare Safety Network-adjusted SSI rate. Its association with climate level and strength was investigated in regression analyses, accounting for respondents' professional background, managerial role and hospital size as confounding factors. RESULTS Plotting climate levels against infection rates revealed a general trend with SSI rate decreasing as the safety climate increased, but none of the associations were significant (5% level). Linear models for hip and knee arthroplasties showed a negative association between SSI rate and climate perception (p=0.02). For climate strength, there were no consistent patterns, indicating that alignment of perceptions was not associated with lower infection rates. Being in a managerial role and being a physician (vs a nurse) had a positive effect on climate levels regarding SSI in hip and knee arthroplasties, whereas larger hospital size had a negative effect. CONCLUSIONS This study suggests a possible negative correlation between climate level and SSI rate, while for climate strength, no associations were found. Future research should study safety climate more specifically related to infection prevention measures to establish clearer links.
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Affiliation(s)
- Yvonne Pfeiffer
- Research department, Stiftung fur Patientensicherheit, Zurich, Switzerland
| | - Andrew Atkinson
- Department of Infectious Diseases, Inselspital University Hospital Bern, Bern, Switzerland
| | - Judith Maag
- Department of Infectious Diseases, Inselspital University Hospital Bern, Bern, Switzerland
- Swissnoso, National Center for Infection Control, Bern, Switzerland
| | - Michael A Lane
- Quality & Safety Operations, Parkland Health, Dallas, Texas, USA
| | - David Schwappach
- Institute of Social and Preventive Medicine, Universität Bern, Bern, Switzerland
| | - Jonas Marschall
- Department of Infectious Diseases, Inselspital University Hospital Bern, Bern, Switzerland
- Swissnoso, National Center for Infection Control, Bern, Switzerland
- Division of Infectious Diseases, Washington University School of Medicine, St Louis, Missouri, USA
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Vikan M, Haugen AS, Bjørnnes AK, Valeberg BT, Deilkås ECT, Danielsen SO. The association between patient safety culture and adverse events - a scoping review. BMC Health Serv Res 2023; 23:300. [PMID: 36991426 DOI: 10.1186/s12913-023-09332-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Adverse events (AEs) affect 10% of in-hospital patients, causing increased costs, injuries, disability and mortality. Patient safety culture (PSC) is an indicator of quality in healthcare services and is thus perceived as a proxy for the quality of care. Previous studies show variation in the association between PSC scores and AE rates. The main objective of this scoping review is to summarise the evidence on the association between PSC scores and AE rates in healthcare services. In addition, map the characteristics and the applied research methodology in the included studies, and study the strengths and limitations of the evidence. METHODS We applied a scoping review methodology to answer the broad research questions of this study, following the PRISMA-ScR checklist. A systematic search in seven databases was conducted in January 2022. The records were screened independently against eligibility criteria using Rayyan software, and the extracted data were collated in a charting form. Descriptive representations and tables display the systematic mapping of the literature. RESULTS We included 34 out of 1,743 screened articles. The mapping demonstrated a statistical association in 76% of the studies, where increased PSC scores were associated with reduced AE rates. Most of the studies had a multicentre design and were conducted in-hospital in high-income countries. The methodological approaches to measuring the association varied, including missing reports on the tools` validation and participants, different medical specialties, and work unit level of measurements. In addition, the review identified a lack of eligible studies for meta-analysis and synthesis and demonstrated a need for an in-depth understanding of the association, including context complexity. CONCLUSIONS We found that the vast majority of studies report reduced AE rates when PSC scores increase. This review demonstrates a lack of studies from primary care and low- and- middle-income countries. There is a discrepancy in utilised concepts and methodology, hence there is a need for a broader understanding of the concepts and the contextual factors, and more uniform methodology. Longitudinal prospective studies with higher quality can enhance efforts to improve patient safety.
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Affiliation(s)
- Magnhild Vikan
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Arvid Steinar Haugen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Berit Taraldsen Valeberg
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- University of South-Eastern Norway, Drammen, Norway
| | | | - Stein Ove Danielsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Abdulla MA, Habas E, Al Halabi A, Hassan M, Sohail F, Alajmi J, Ghazouani H. An Evaluation of Healthcare Safety Culture Among Healthcare Professionals in Secondary and Tertiary Public Hospitals in the Middle East Region. Cureus 2023; 15:e35299. [PMID: 36974259 PMCID: PMC10039764 DOI: 10.7759/cureus.35299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 02/24/2023] Open
Abstract
Background and aim The provision of quality healthcare is initiated by a culture of patient safety. Understanding the patient safety culture (PSC) is a critical concept for all healthcare workers. We conducted this study to evaluate the PSC understanding among the Hamad Medical Corporation (HMC) staff members. Furthermore, to establish a local (HMC) reference point for providing quality health care based on a culture of patient safety. Method A Hospital Patient Safety Culture Survey (HSOPSC) was presented to our health system employees to assess their perceptions and understandings of PSC. The survey was self-administered. STATA Package version 12.0 culture software was used to analyze these data in terms of descriptive, correlational, and multivariate ordinal regression. Results This study targeted to survey 6,538 employees in HMC facilities, but only 5,583 responded, resulting in a percentage response rate of 85.4%. Ten facilities achieved 100% participation, and other HMC facilities had response rates ranging from 71.2% to 97.5%. Approximately 88.0% of the responders had direct patient contact. The HSOPSC survey resulted in an overall positive response rate of 62.4%. The dimensions with the highest positive response score were "teamwork within the Unit" followed by "organizational learning/continuous improvement" and "management support for patient safety" with a mean percent positive response (PPR) of 83.1%, 82.0%, and 79.2%, respectively. Conversely, there are three dimensions with the lowest positive response score, including "communication openness," "staffing," and "nonpunitive response to errors," with a mean PPR of 46.6%, 40.1%, and 27.7%, respectively. ANOVA and the student t-test revealed that men (64.3% ± 8.1%), employees with 11-15 years of experience in their specialty (65.8% ± 6.5%), and general hospital type (64.4% ±7.2%), were all significantly associated with differences in the overall perceptions of PSC. According to the study results, there was a moderate correlation between perceptions of PSC at the hospital and the following: Teamwork Across Units (RS= 0.43; p < 0.05), and Frequency of Events Reported (RS= 0.40; p < 0.05.). A regression analysis found that men, workers under 40 years of age, professionals with no direct contact with patients, employees with 11-15 years of experience in their specialty, intensive care staff, and general hospital staff were all significant predictors of overall favorable perceptions of the PSC. Conclusion PSC's understanding of HMC staff is moderate. Furthermore, this is the first study conducted for PSC understanding by the HMC staff in Qatar State. It is eligible to be considered a backbone and reference for new research projects about PSC in Qatari health facilities, if not worldwide.
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Lee SE, Hyunjie L, Sang S. Nurse Managers' Leadership, Patient Safety, and Quality of Care: A Systematic Review. West J Nurs Res 2023; 45:176-185. [PMID: 35876005 DOI: 10.1177/01939459221114079] [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: 12/27/2022]
Abstract
This review examined relationships between nurse unit managers' leadership and patient safety and quality of care outcomes in hospital settings. Employing four databases (CINAHL, Embase, PubMed, and Web of Science) and ancestry searches, we identified 14 English-language, peer-reviewed, primary studies that examined such relationships using quantitative analyses. The studies were published between 2012 and 2021, and most used a cross-sectional design. Each study's quality was assessed using the Mixed-Method Appraisal Tool. In synthesizing results by categorizing outcomes, we found a positive trend in associations between effective nurse unit manager leadership and better outcomes, including fewer patient adverse events, increased nurse error reporting, and higher patient satisfaction and care quality. However, the heterogeneity of leadership measurement approaches and outcomes limited integration of study findings. Future researchers should clearly define study concepts to support interpretation of their findings and should use a suitable theoretical framework to help determine appropriate units of analysis.
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Affiliation(s)
- Seung Eun Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Lee Hyunjie
- Severance Hospital, College of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Somin Sang
- College of Nursing, Graduate School, Yonsei University, Seoul, South Korea
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Ha TTN, Thanh PQ, Huong TL, Anh VT, Tu NM, Tien PH, Ha BTT. Nurses' perceptions about patient safety culture in public hospital in Vietnam. Appl Nurs Res 2023; 69:151650. [PMID: 36635007 DOI: 10.1016/j.apnr.2022.151650] [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: 03/03/2022] [Revised: 09/27/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
AIM This paper is aimed to assess nurses' perceptions of patient safety culture in four public general hospitals in Hanoi, Vietnam. BACKGROUND Patient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of nurses' perceptions on existing hospital patient safety culture (PSC) is the first step to promote PSC. METHODS The cross-sectional study surveyed 705 nurses utilizing the validated Hospital Survey on Patient Safety Culture (HSOPSC) in an online format. RESULTS The average positive response rate was high at 72.8 % and varied from 52.9 % to 93.4 %. The strongest areas are teamwork within units (93.7 %) and supervisor/manager expectations and actions promoting patient safety (85.0 %). The areas for improvement are staffing (52.9 %) and non-punitive response to error (57.6 %). The communication openness, staffing, frequency of events reported, lengths of services in hospital and unit are significant factors that predict the overall patient safety grade. CONCLUSIONS Initiatives are necessary to improve response to errors, staffing, and error reporting. Nurse managers could develop and implement interventions and program to improve patient safety, including providing education related to patient safety culture, encouraging staff to notify incidents and avoiding punitive responses.
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Affiliation(s)
- Tran Thi Nhi Ha
- Hanoi Department of Health, No 4 Son Tay, Ba Dinh, Hanoi 100000, Viet Nam.
| | - Pham Quoc Thanh
- Hanoi University of Public Health, 1A Duc Thang road, Bac Tu Liem district, Hanoi 100000, Viet Nam.
| | - Tran Lien Huong
- Saint Paul Hospital, No. 12 Chu Van An, Ba Dinh district, Hanoi 100000, Viet Nam
| | - Vu Tuan Anh
- Genetal Hospital of Agricultural, Thanh Tri district, Hanoi 100000, Viet Nam
| | - Nguyen Minh Tu
- Phuc Tho Hospital, Phuc Tho Town, Phuc Tho District, Hanoi 100000, Viet Nam
| | - Pham Hung Tien
- Hanoi University of Public Health, 1A Duc Thang road, Bac Tu Liem district, Hanoi 100000, Viet Nam
| | - Bui Thi Thu Ha
- Hanoi University of Public Health, 1A Duc Thang road, Bac Tu Liem district, Hanoi 100000, Viet Nam
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Wei SY, Kuo YK. The relationship among safety leadership, risk perception, safety culture, and safety performance: Military volunteer soldiers as a case study. Front Psychol 2023; 14:1000331. [PMID: 36910780 PMCID: PMC9995976 DOI: 10.3389/fpsyg.2023.1000331] [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: 07/22/2022] [Accepted: 02/02/2023] [Indexed: 02/25/2023] Open
Abstract
Safety is fundamental to any organization; if not based on safety, organizational decision-making and management would be meaningless. For a country, soldiers are responsible for national security; they serve as a barrier that defends a country against external invasive forces, thus assuming great missions and responsibilities on their shoulders. To ensure soldiers fulfill their duties of protecting the country and the people, they should gain clear risk perception, which should be instilled into them during their daily combat readiness training. Only when their performances meet safety criteria can they become a strong fighting force. This study recruited military volunteer soldiers as its research participants and employed convenience sampling to distribute questionnaires. In total, this research collected 725 valid copies, of which the data were used to explore the relationship among safety leadership, risk perception, safety culture, and safety performance. To achieve this goal, this study proposed some research hypotheses based on literature review. The hypotheses were all verified via latent variable modeling and multiple hierarchical regression analysis after the reliability and validity of each construct had been tested via confirmatory factor analysis. The research results showed that the more deeply military volunteer soldiers sense safety leadership, the clearer their risk perception will be and the more helpful it would be in achieving safety performance. It is worth mentioning that risk perception can serve as a mediator while safety culture can mediate the relationship between safety leadership and safety performance. Lastly, the research proposes suggestions in the section of conclusions, which provides reference to the combat readiness training and daily tasks of soldiers.
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Affiliation(s)
- Siao-Yun Wei
- Department of Banking and Finance, Commercial College, Chinese Culture University, Taipei, Taiwan
| | - Yen-Ku Kuo
- Bachelor Program of Leisure Management, Commercial College, Chinese Culture University, Taipei, Taiwan
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Indarwati R, Efendi F, Fauziningtyas R, Fauziah A, Sudarsiwi NP. Efforts to Improve the Safety Culture of the Elderly in Nursing Homes: A Qualitative Study. Risk Manag Healthc Policy 2023; 16:393-400. [PMID: 36936883 PMCID: PMC10015942 DOI: 10.2147/rmhp.s399826] [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: 12/13/2022] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
Introduction The attention to building a safety culture in nursing homes is relatively less when compared to hospitals. Good patient safety will improve the quality of health services and minimize incidents related to patient safety. This study aims to look at efforts that can be made to improve safety culture in nursing homes. Materials and Methods The research design uses phenomenological qualitative with in-depth interviews. Purposive sampling was used with interpretive phenomenological analysis. Participants were 29 staff from four government and private institutions in East Java, Indonesia. Results The sub-themes resulting from the research efforts to improve the safety culture of the elderly in nursing homes are the provision of new staff orientation, training, improvement of infrastructure, and procurement of security staff. Conclusion The analysis shows that efforts to improve safety culture can be carried out with various strategies by paying attention to risk assessment steps, patient risk identification, and management, incident reporting, and analysis, the ability to learn from incidents and their follow-up, as well as implementing solutions to minimize risks and prevent them from occurring injury. Safety culture plays an essential role in improving the quality of care.
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Affiliation(s)
- Retno Indarwati
- Faculty of Nursing, Universitas Airlangga, Campus C Mulyorejo, Surabaya, East Java, 60115, Indonesia
- Correspondence: Retno Indarwati, Email
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Campus C Mulyorejo, Surabaya, East Java, 60115, Indonesia
| | - Rista Fauziningtyas
- Faculty of Nursing, Universitas Airlangga, Campus C Mulyorejo, Surabaya, East Java, 60115, Indonesia
| | - Anis Fauziah
- Faculty of Nursing, Universitas Airlangga, Campus C Mulyorejo, Surabaya, East Java, 60115, Indonesia
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Lee S, Lee JY, Kim H, Lee K, Lee T. Advanced Practice Nurses' Experiences on Patient Safety Culture in Hospital-Based Home Healthcare: A Qualitative Descriptive Study. Healthc Policy 2022; 15:2297-2309. [PMID: 36504488 PMCID: PMC9733626 DOI: 10.2147/rmhp.s388902] [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: 09/07/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose Despite the increasing interest in patient safety, most research have been conducted in hospital settings, thereby demonstrating an overall lack of research regarding patient safety culture in home healthcare. South Korea has three types of home healthcare services based on hospitals, public health centers, and long-term care insurance. Home healthcare nurses in hospitals require a master's degree and advanced nursing skills. They play important roles in ensuring patients' safe transition into home health care. This study aimed to explore the experience of patient safety culture among South Korean advanced practice nurses in hospital-based home healthcare. Methods This qualitative descriptive study was conducted through purposive sampling, whereby twenty advanced practice nurses involved in home healthcare were recruited from twelve hospitals located in three different cities throughout South Korea. Face-to-face semi-structured interviews were conducted, and the collected data were analyzed through inductive and deductive content analyses. Results Three main categories were finally confirmed: (a) teamwork climate, (b) safety climate, and (c) working condition. The sub-categories of the teamwork climate included the collaboration between patients, caregivers, and nurses, collaboration within medical institutions, and collaboration among the individuals involved in community partnerships. The sub-categories of the safety climate included nurses' commitment to patient safety, the associated institutions' commitment to patient safety, and the government's commitment to patient safety. The sub-categories of the working condition included the frontline working environments and the associated institutions' support aimed at ensuring effective working environments. Conclusion Cultivating patient safety culture is crucial for ensuring the safe transition of patients from acute care hospitals to home healthcare. This study revealed significant aspects of patient safety culture in hospital-based home healthcare, allowing for the continuum of care among the associated patients. Such aspects include communicating with caregivers, building community partnerships, understanding unexpected home environments, and enhancing the safety of nurses.
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Affiliation(s)
- Soohee Lee
- College of Nursing, Gachon University, Incheon, South Korea
| | - Ji Yeon Lee
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Hyejin Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Kayoung Lee
- College of Nursing, Gachon University, Incheon, South Korea,Correspondence: Kayoung Lee, Gachon University College of Nursing, 191 Hambakmoero, Yeonsu-Gu, Incheon, 21936, South Korea, Tel +82-32-820-4227, Email
| | - Taewha Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea,Taewha Lee, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea, Tel +82-2-2227-8303, Email
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Huang H, Xiao L, Chen Z, Cao S, Zheng S, Zhao Q, Xiao M. A National Study of Patient Safety Culture and Patient Safety Goal in Chinese Hospitals. J Patient Saf 2022; 18:e1167-e1173. [PMID: 35617631 PMCID: PMC9698193 DOI: 10.1097/pts.0000000000001045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This study aimed to measure the patient safety culture and the current practice of patient safety goals in China. METHODS This cross-sectional survey was conducted between November 2020 and November 2021. The 12-dimensions Hospital Survey on Patient Safety Culture questionnaire and the 14-items Survey on the Current Practice of Patient Safety Goal questionnaire were electronically distributed to 8164 healthcare providers across 26 provinces in China. Data were analyzed using descriptive statistics, correlation analysis, and multivariate linear regression. RESULTS A total of 8164 surveys were received, of which 7765 were valid and analyzed. The average positive response rate for the Hospital Survey on Patient Safety Culture survey was 69.68% (43.41%-91.54%). The percentage of positive responses in 5 dimensions (organizational learning, teamwork within units, feedback about error, management support for safety, and teamwork across units) was above the control limits, and 3 (nonpunitive response to error, staffing, and frequency of event reporting) were below the control limits. The average positive response rate for the Survey on the Current Practice of Patient Safety Goal survey was 96.11%. Patient safety culture was positively related to the current practice of patient safety goals ( r = 0.34, P < 0.001). CONCLUSIONS Our study concludes that although healthcare providers in China feel positively toward patient safety culture and practicably toward patient safety goals, considerable work is still needed to promote a patient safety movement.
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Affiliation(s)
- Huanhuan Huang
- From the Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Ling Xiao
- From the Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing
- Department of Encephalopathy, Chenzhou Traditional Chinese Medicine Hospital, Hunan
| | | | - Songmei Cao
- From the Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | | | - Qinghua Zhao
- From the Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Mingzhao Xiao
- Urology, Urologist, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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The relationship between patient safety culture and patient safety competency with adverse events: a multicenter cross-sectional study. BMC Nurs 2022; 21:292. [PMID: 36319970 PMCID: PMC9628064 DOI: 10.1186/s12912-022-01076-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
Abstract
Background Patient safety culture and patient safety competency could be associated with adverse events (AEs). This study aimed to investigate the associations between nurses’ perceptions of patient safety culture, patient safety competency, and AEs. Methods A cross-sectional study was carried out among 338 nurses employed in three university hospitals in Qom, Iran between 17 August 2021 and 12 November 2021. Data were collected using three questionnaires: patient safety culture, patient safety competency, and AEs. Data were analyzed using SPSS-21 software. A multiple logistic regression model was used to analyze the data. Results The results of this study showed that medication errors were significantly associated with “frequency of events reported” (OR = 0.706, P = 0.012), “supervisor/manager expectations and actions promoting patient safety” (OR = 0.733, P = 0.048), and “management support for patient safety” (OR = 0.755, P = 0.012). Pressure ulcers were significantly associated with “supervisor/manager expectations and actions promoting patient safety” (OR = 0.729, P = 0.039), “handoffs and transition” (OR = 0.707, P = 0.034), and “comfort speaking up about patient safety” (OR = 0.614, P = 0.016). Falls were significantly associated with “teamwork within units” (OR = 0.735, P = 0.031), “feedback and communication about error” (OR = 0.756, P = 0.046), and “handoffs and transition” (OR = 0.660, P = 0.012). The use of restraints for ≥8 hr. was significantly associated with “management support for patient safety” (OR = 0.701, P = 0.021). Conclusions According to the results of this study, AEs are associated with some dimensions of patient safety culture and patient safety competency. Further research is needed to confirm these findings and identify interventions to reduce the occurrence of AEs.
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Østergaard D, Madsen MD, Ersbøll AK, Frappart HS, Kure JH, Kristensen S. Patient safety culture and associated factors in secondary health care of the Capital Region of Denmark: influence of specialty, healthcare profession and gender. BMJ Open Qual 2022; 11:bmjoq-2022-001908. [PMID: 36288806 PMCID: PMC9615985 DOI: 10.1136/bmjoq-2022-001908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/15/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND We aimed to explore (1) the influence of healthcare professionals' (HCPs') specialty, profession, gender and length of employment on their perception of six dimensions of patient safety culture (PSC) and (2) the relation between these characteristics and the two dimensions of safety climate and perception of management. METHODS In a cross-sectional study, a Danish version of the Safety Attitudes Questionnaire was sent to all HCPs at a large regional hospital organisation. This included hospitals, the Emergency Services, the Regional Pharmacy and the Centre for Diabetes corporations. A total of 30 230 HCPs received the survey. Differences between specialties, professions, gender and years of employment were tested for each dimension of PSC. Differences in mean attitude scores were tested using analysis of variance and differences in having a positive attitude were tested using logistic regression. RESULTS In total, 15 119 (50%) HCPs returned the survey. Significant differences are seen across hospitals and corporations for all dimensions of PSC. The proportion of HCPs with a positive attitude was largest regarding job satisfaction (74.8%) and lowest regarding perception of management (43.9%). Significant differences are seen in physicians' and nurses' perception of PSC in the different specialties within all dimensions of PSC except for the dimension of recognition of stress. Significant differences in positive perception of teamwork climate are seen between anaesthesiologists' (69.4%) and surgeons' (41.7%). No significant gender differences were found between physicians' and nurses' perception of safety climate and of management. In addition, we found an influence of years of employment on PSC. DISCUSSION Significant differences were found in HCPs' perception of PSC between corporations, specialties and professions. The lowest proportion of HCPs with a positive perception of PSC was found within the dimensions of safety climate and perception of management. These differences may have implications for teamwork and patient safety.
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Affiliation(s)
- Doris Østergaard
- Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Marlene Dyrløv Madsen
- Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, Copenhagen, Denmark
| | | | - Helle Søgaard Frappart
- Unit for Quality and Patient Safety in Health Care, Capital Region of Denmark, Hillerød, Denmark
| | - Josefine Haahr Kure
- Unit for Quality and Patient Safety in Health Care, Capital Region of Denmark, Hillerød, Denmark
| | - Solvejg Kristensen
- Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, Copenhagen, Denmark
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Wegener J, St Pierre M, Keil O, Eismann H. Correlation between safety attitudes and early adoption of cognitive aids in the German culture sphere: a multicenter survey study. BMC Health Serv Res 2022; 22:1215. [PMID: 36175882 PMCID: PMC9522441 DOI: 10.1186/s12913-022-08581-3] [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: 05/19/2022] [Accepted: 09/15/2022] [Indexed: 11/26/2022] Open
Abstract
Background Cognitive Aids (checklists) are a common tool to improve patient safety. But the factors for their successful implementation and continuous use are not yet fully understood. Recent publications suggest safety culture to play a key role in this context. However, the effects on the outcome of implementation measures remain unclear. Hospitals and clinics that are involved in cognitive aid development and research might have significantly different safety cultures than their counterparts, resulting in skewed assessments of proper implementation. Therefore, the objective of this study was to assess the correlation between cognitive aid implementation and safety attitudes of staff members in early adopting and later adopting clinics. Methods An online survey of the Safety Attitudes Questionnaire (SAQ) was carried out in German anaesthesiology departments during the initial implementation of a new checklist for emergencies during anesthesia (“eGENA” app). Subsequently an analysis between subgroups (“eGENA” app usage and occupation), with Kruskal–Wallis- and Mann–Whitney-U-Tests was carried out for the general SAQ, as well as it six subscales. Results Departments that introduced “eGENA” app (Median 3,74, IQR 0,90) reported a significantly higher median SAQ (U (NeGENA = 6, Nnon eGENA = 14) = 70,0, z = 2,31, p = 0,02, r = 0,516) than their counterparts (Median 2,82, IQR 0,77) with significant differences in the dimensions teamwork climate, work satisfaction, perception of management and working conditions. Conclusion Early adopters of cognitive aids are likely to show a significantly higher perception of safety culture in the SAQ. Consequently, successful implementation steps from these settings might not be sufficient in different clinics. Therefore, further investigation of the effects of safety culture on cognitive aid implementation should be conducted.
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Affiliation(s)
- Justus Wegener
- Business School, Middlesex University London, The Burroughs, London, NW4 4BT, UK
| | - Michael St Pierre
- Anästhesiologische Klinik, Universitätsklinikum Erlangen, Krankenhaustrasse 12, 91054, Erlangen, Germany
| | - Oliver Keil
- Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Hendrik Eismann
- Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Cetin K, Worku D, Demtse A, Melberg A, Miljeteig I. "Death audit is a fight" - provider perspectives on the ethics of the Maternal and Perinatal Death Surveillance and Response (MPDSR) system in Ethiopia. BMC Health Serv Res 2022; 22:1214. [PMID: 36175949 PMCID: PMC9524002 DOI: 10.1186/s12913-022-08568-0] [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: 03/09/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal and neonatal health are regarded as important indicators of health in most countries. Death auditing through, for example, the Maternal and Perinatal Death Surveillance and Response (MPDSR) is viewed as key to preventing maternal and newborn mortality. However, little is known about the implications of implementing perinatal auditing for healthcare professionals in low-income contexts. This study aimed to explore the ethical and practical consequences clinicians experience concerning MPDSR reporting practices in Ethiopia. METHODS: Qualitative semi-structured in-depth individual interviews were conducted with 16 healthcare workers across professions at selected facilities in Ethiopia. The interview questions were related to clinicians' experiences with, and perceptions of, death auditing. Their strategies for coping with newborn losses and the related reporting practices were also explored. The material was analyzed following systematic text condensation, and the NVivo11 software was used for organizing and coding the data material. RESULTS Participants experienced fear of punishment and blame in relation to the perinatal death auditing process. They found that auditing did not contribute to reducing perinatal deaths and that their motivation to stick to the obligation was negatively affected by this. Performing audits without available resources to provide optimal care or support in the current system was perceived as unfair. Some hid information or misreported information in order to avoid accusations of misconduct when they felt they were not to blame for the baby's death. Coping strategies such as engaging in exceedingly larger work efforts, overtreating patients, or avoiding complicated medical cases were described. CONCLUSIONS Experiencing perinatal death and death reporting constitutes a double burden for the involved healthcare workers. The preventability of perinatal death is perceived as context-dependent, and both clinicians and the healthcare system would benefit from a safe and blame-free reporting environment. To support these healthcare workers in a challenging clinical reality, guidelines and action plans that are specific to the Ethiopian context are needed.
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Affiliation(s)
- Kaya Cetin
- Bergen Center for Ethics and Priority Setting, University of Bergen, Bergen, Norway.
| | - Dawit Worku
- Addis Center for Ethics and Priority Setting, Addis Ababa University, Addis Ababa, Ethiopia
| | - Asrat Demtse
- Addis Center for Ethics and Priority Setting, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andrea Melberg
- Bergen Center for Ethics and Priority Setting, University of Bergen, Bergen, Norway
| | - Ingrid Miljeteig
- Bergen Center for Ethics and Priority Setting, University of Bergen, Bergen, Norway
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Abdelaliem SMF, Alsenany SA. Factors Affecting Patient Safety Culture from Nurses’ Perspectives for Sustainable Nursing Practice. Healthcare (Basel) 2022; 10:healthcare10101889. [PMID: 36292336 PMCID: PMC9602037 DOI: 10.3390/healthcare10101889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022] Open
Abstract
Individual and group beliefs, attitudes, perceptions, competences, and behavioral patterns all contribute to the safety culture of a healthcare company. The study’s goal is to assess nurses’ perceptions of elements that influence patient safety culture in order to promote long-term nursing practice. A descriptive cross-sectional study design was done among a sample of 146 nurses who were recruited from one hospital in Egypt. They completed a self-administered, printed questionnaire. The questionnaire assessed participants’ socio-demographic data and their perception regarding patient safety culture for sustainable nursing practices. The findings revealed that nursing staff had a high perception regarding patient safety culture a with mean score (159.94 ± 7.864). Also, the highest percentage (74.66%) of had no safety events reported yearly. Creating a unit-specific patient safety culture suited to the competences of the unit’s RNs in patient safety practice would be crucial to increasing and sustaining high levels of patient safety attitudes, skills, and knowledge among the unit’s RNs, influencing patient safety. When implementing interventions to promote patient safety and reporting culture in hospitals, policymakers, hospital administrators, and nurse executives should take the current findings into account. A multidimensional network intervention addressing many elements of patient safety culture and integrating different organizational levels should be implemented to enhance patient safety and a no-blame culture.
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Affiliation(s)
- Sally Mohammed Farghaly Abdelaliem
- Department of Nursing Management and Education, College of Nursing, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
- Correspondence:
| | - Samira Ahmed Alsenany
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
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Tran TNH, Pham QT, Tran LH, Vu TA, Nguyen MT, Pham HT, Le TT, Bui TTH. Comparison of Perceptions About Patient Safety Culture Between Physicians and Nurses in Public Hospitals in Vietnam. Healthc Policy 2022; 15:1695-1704. [PMID: 36097561 PMCID: PMC9464021 DOI: 10.2147/rmhp.s373249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/27/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Patient safety culture (PSC) is a vital component in ensuring high-quality and safe patient care. Assessment of physicians' and nurses' perceptions of existing hospital PSC is the first step to promoting PSC. This paper is aimed to assess physicians' and nurses' perceptions of PSC in 5 public general hospitals in Hanoi, Vietnam. Methods This cross-sectional study surveyed 410 physicians and 824 nurses utilizing the validated Hospital Survey on Patient Safety Culture in an online format. Results The composite positive physician's perception of PSC varied from 47.8 to 89.6% with the lowest composite score of patient safety for "staffing" (47.8%) and the highest composite score for "teamwork within units" (89.6%). The composite positive responses for perception among nurses varied from 51.3 to 94.2% with the lowest composite score of patient safety for "staffing" (51.3%) and the highest composite score for "teamwork within units" (94.2%). Conclusion The mean scores for "supervisor/manager expectations"; "staffing", "management support for patient safety", "teamwork across units", "handoffs and transitions" among nurses were significantly higher than that among physicians (p<0.05). About two-thirds of physicians and nurses reported no event in the past 12 months (62.8 and 71.7%, respectively). The nurses reported significantly higher patient grades (every good and excellent) than physicians (75% vs 67.1%, p <0.001). Hospitals could develop and implement intervention programs to improve patient safety, including providing interventions on teamwork and communication, encouraging staff to notify incidents, and avoiding punitive responses.
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Affiliation(s)
| | - Quoc Thanh Pham
- Center of Digital Health, Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Tuan Anh Vu
- Medicine Department, Agriculture General Hospital, Hanoi, Vietnam
| | | | - Hung Tien Pham
- Faculty of Clinical Medicine, Hanoi University of Public Health, Hanoi, Vietnam
| | - Thanh Tong Le
- Student, Hanoi University of Public Health, Hanoi, Vietnam
| | - Thi Thu Ha Bui
- Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
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Ghanbari-Afra L, Adib-Hajbaghery M, Dianati M. Human Caring: A Concept Analysis. J Caring Sci 2022; 11:246-254. [DOI: 10.34172/jcs.2022.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/17/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction: Human caring combines science, art, and humanity. Humanity is the heart of care and interpersonal interactions. Despite the critical emphasis on human caring and concern for nursing care without humanity, there is no clear definition for human caring in nursing. This study aimed to analyze the concept of human caring. Methods: Walker and Avant’s strategy for concept analysis was used. Electronic databases such as PubMed, Scopus, Ovid, Google Scholar, Magiran, Iran Doc, SID, and a number of dictionaries were searched without any limitation in date. Search keywords were "care", "caring", "human caring", "humanization", "patient care", "comprehensive care" and "nursing care". We searched all documents published before September 2020. In the initial search, 1637 articles were found but finally, 39 relevant articles remained in the study. Results: The nine defining attributes of human caring were establishing therapeutic communication, presence at the patient bedside, empathy, providing scientific care, subjectivity, dynamicity, respecting the patient’s rights and ethics of care, helping the patient achieve a feeling of well-being, and art and creativity. Antecedents of human caring were categorized into three categories namely, human, personal, and organizational factors. The consequences were also categorized into consequences related to nurse, profession, patient, and organization. Conclusion: A theoretical definition and a conceptual model of human caring were developed. This concept should be included in the nursing curricula at all undergraduate and graduate levels and even in nurses’ in-service training programs.
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Affiliation(s)
- Leila Ghanbari-Afra
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Mansour Dianati
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
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