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Watson E, Dowson L, Dunt D, Thursky K, Worth LJ, Sluggett JK, Appathurai A, Bennett N. Identifying barriers and enablers to participation in infection surveillance in Australian residential aged care facilities. BMC Public Health 2023; 23:2160. [PMID: 37924023 PMCID: PMC10625226 DOI: 10.1186/s12889-023-16891-2] [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: 07/16/2023] [Accepted: 10/04/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Infection surveillance is a vital part of infection prevention and control activities for the aged care sector. In Australia there are two currently available infection and antimicrobial use surveillance programs for residential aged care facilities. These programs are not mandated nor available to all facilities. Development of a new surveillance program will provide standardised surveillance for all facilities in Australia. METHODS This study aimed to assess barriers and enablers to participation in the two existing infection and antimicrobial use surveillance programs, to improve development and implementation of a new program. A mixed-methods study was performed. Aged Care staff involved in infection surveillance were invited to participate in focus groups and complete an online survey comprising 17 items. Interviews were transcribed and analysed using the COM-B framework. RESULTS Twenty-nine staff took part in the focus groups and two hundred took part in the survey. Barriers to participating in aged care infection surveillance programs were the time needed to collect and enter data, competing priority tasks, limited understanding of surveillance from some staff, difficulty engaging clinicians, and staff fatigue after the COVID-19 pandemic. Factors that enabled participation were previous experience with surveillance, and sharing responsibilities, educational materials and using data for benchmarking and to improve practice. CONCLUSION Streamlined and simple data entry methods will reduce the burden of surveillance on staff. Education materials will be vital for the implementation of a new surveillance program. These materials must be tailored to different aged care workers, specific to the aged care context and provide guidance on how to use surveillance results to improve practice.
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Affiliation(s)
- Eliza Watson
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, VIC, 3000, Australia
| | - Leslie Dowson
- National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - David Dunt
- Professor Emeritus, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Karin Thursky
- National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, The University of Melbourne, Parkville, VIC, 3010, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010 , Australia
- The Royal Melbourne Hospital Guidance Group, Melbourne, VIC, 3000, Australia
| | - Leon J Worth
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, VIC, 3000, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010 , Australia
- Department of Medicine, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Janet K Sluggett
- University of South Australia, UniSA Allied Health and Human Performance, Adelaide, SA, 5001, Australia
- Registry of Senior Australians (ROSA), Healthy Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, SA, 5001, Australia
| | - Amanda Appathurai
- National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Noleen Bennett
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, VIC, 3000, Australia.
- National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, The University of Melbourne, Parkville, VIC, 3010, Australia.
- Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.
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Nasiri N, Mangolian Shahrbabaki P, Sharifi A, Ghasemzadeh I, Khalili M, Karamoozian A, Khalooei A, Haghdoost A, Sharifi H. Barriers and Problems in Implementing Health-Associated Infections Surveillance Systems in Iran: A Qualitative Study. Med J Islam Repub Iran 2023; 37:57. [PMID: 37457414 PMCID: PMC10349358 DOI: 10.47176/mjiri.37.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Indexed: 07/18/2023] Open
Abstract
Background Healthcare-associated infections (HAIs) are among the most critical challenges for patients and healthcare providers. To achieve the goals of the surveillance system, it is necessary to identify its barriers and problems. This study aimed to identify the barriers and problems of the surveillance system for HAIs. Methods This qualitative study was conducted using the content analysis method to investigate the challenges of this surveillance system from the perspective of 18 infection control nurses from hospitals in different cities of Iran with work experience of 1 to 15 years. Data were collected through semi-structured interviews and analyzed using the Lundman and Graneheim qualitative content analysis method. Results In this study, we found 2 categories and 7 subcategories. Two categories were barriers related to human resources and organizational barriers to infection control. The 7 subcategories included weakness of medical staff in adherence to health principles, obstacles related to patients, high workload and insufficient motivation, lack of staff knowledge, lack of human resources, functional and logistical weaknesses, and weaknesses in the surveillance system. Conclusion To reduce problems and improve HAIs reporting, the HAIs surveillance system needs the support of health system officials and managers. This administrative and support focus can establish the framework for removing and lowering other barriers, such as the number of reported cases, physician and staff noncooperation, and the prevalence of HAIs. It can also bring HAIs cases closer to reality.
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Affiliation(s)
- Naser Nasiri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV
Surveillance, Institute for Futures Studies in Health, Kerman University of Medical
Sciences, Kerman, Iran
| | | | - Ali Sharifi
- Department of Ophthalmology, Shafa Hospital, Afzalipour School of Medicine,
Kerman University of Medical Sciences, Kerman, Iran
| | - Iman Ghasemzadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV
Surveillance, Institute for Futures Studies in Health, Kerman University of Medical
Sciences, Kerman, Iran
| | - Malahat Khalili
- The Michael G. DeGroote Institute for Pain Research and Care, McMaster
University, Hamilton, Ontario, Canada
| | - Ali Karamoozian
- Modeling in Health Research Center, Institute for Futures Studies in Health,
Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Khalooei
- Social Determinants of Health Research Center, Institute for Futures Studies in
Health, Kerman University of Medical Sciences, Kerman, Iran
| | - AliAkbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV
Surveillance, Institute for Futures Studies in Health, Kerman University of Medical
Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV
Surveillance, Institute for Futures Studies in Health, Kerman University of Medical
Sciences, Kerman, Iran
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Supriadi IR, Haanappel CP, Saptawati L, Widodo NH, Sitohang G, Usman Y, Anom IB, Saraswati RD, Heger M, Doevendans PA, Satari HI, Voor in ‘t holt AF, Severin JA. Infection prevention and control in Indonesian hospitals: identification of strengths, gaps, and challenges. Antimicrob Resist Infect Control 2023; 12:6. [PMID: 36732802 PMCID: PMC9894741 DOI: 10.1186/s13756-023-01211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/22/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Infection prevention and control (IPC) in hospitals is key to safe patient care. There is currently no data regarding the implementation of IPC in hospitals in Indonesia. The aim of this study was to assess the existing IPC level in a nationwide survey, using the World Health Organization (WHO) IPC assessment framework tool (IPCAF), and to identify strengths, gaps, and challenges. METHODS A cross-sectional study was conducted from July to November 2021. Of all general hospitals in Indonesia, 20% (N = 475) were selected using stratified random sampling based on class (A, B, C and D; class D with a maximum of 50 beds and class A with ≥ 250 beds) and region. The IPCAF was translated into Indonesian and tested in four hospitals. Questions were added regarding challenges in the implementation of IPC. Quantitative IPCAF scores are reported as median (minimum-maximum). IPC levels were calculated according to WHO tools. RESULTS In total, 355 hospitals (74.7%) participated in this study. The overall median IPCAF score was 620.0 (535.0-687.5). The level of IPC was mostly assessed as advanced (56.9% of hospitals), followed by intermediate (35.8%), basic (7.0%) and inadequate (0.3%). In the eastern region of the country, the majority of hospitals scored intermediate level. Of the eight core components, the one with the highest score was IPC guidelines. Almost all hospitals had guidelines on the most important topics, including hand hygiene. Core components with the lowest score were surveillance of healthcare-associated infections (HAIs), education and training, and multimodal strategies. Although > 90% of hospitals indicated that surveillance of HAIs was performed, 57.2% reported no availability of adequate microbiology laboratory capacity to support HAIs surveillance. The most frequently reported challenges in the implementation of IPC were communication with the management of the hospitals, followed by the unavailability of antimicrobial susceptibility testing results and insufficient staffing of full-time IPC nurses. CONCLUSION The IPC level in the majority of Indonesian hospitals was assessed as advanced, but there was no even distribution over the country. The IPCAF in combination with interviews identified several priority areas for interventions to improve IPC in Indonesian hospitals.
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Affiliation(s)
- Indri Rooslamiati Supriadi
- Center for Health Policy on Resilience System and Resource, Health Policy Agency, Ministry of Health of Indonesia, Percetakan Negara 23, Jakarta, Indonesia. .,Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands. .,Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
| | - Cynthia P. Haanappel
- grid.5645.2000000040459992XDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Leli Saptawati
- grid.444517.70000 0004 1763 5731Department of Microbiology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia ,Department of Microbiology, Moewardi Teaching Hospital, Surakarta, Indonesia
| | - Nani H. Widodo
- grid.415709.e0000 0004 0470 8161Directorate of Referral Health Care, Ministry of Health of Indonesia, Jakarta, Indonesia
| | - Gortap Sitohang
- grid.487294.40000 0000 9485 3821Infection Prevention and Control Committee, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Yuslely Usman
- grid.415709.e0000 0004 0470 8161Center for Health Financing and Decentralization Policy, Health Policy Agency, Ministry of Health of Indonesia, Jakarta, Indonesia
| | - Ida Bagus Anom
- grid.415709.e0000 0004 0470 8161Directorate of Referral Health Care, Ministry of Health of Indonesia, Jakarta, Indonesia
| | - Ratih Dian Saraswati
- grid.415709.e0000 0004 0470 8161Center for Health Policy on Resilience System and Resource, Health Policy Agency, Ministry of Health of Indonesia, Percetakan Negara 23, Jakarta, Indonesia
| | - Michal Heger
- grid.5477.10000000120346234Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands ,grid.5477.10000000120346234Membrane Biochemistry and Biophysics, Department of Chemistry, Faculty of Science, Utrecht University, Utrecht, The Netherlands ,grid.5645.2000000040459992XLaboratory for Experimental Oncology, Department of Pathology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands ,grid.411870.b0000 0001 0063 8301Jiaxing Key Laboratory for Photonanomedicine and Experimental Therapeutics, Department of Pharmaceutics, College of Medicine, Jiaxing University, Jiaxing, Zhejiang China
| | - Pieter A. Doevendans
- grid.7692.a0000000090126352Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Hindra Irawan Satari
- grid.487294.40000 0000 9485 3821Infection Prevention and Control Committee, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia ,grid.9581.50000000120191471Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Anne F. Voor in ‘t holt
- grid.5645.2000000040459992XDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Juliëtte A. Severin
- grid.5645.2000000040459992XDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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Verberk JD, van der Kooi TI, Derde LP, Bonten MJ, de Greeff SC, van Mourik MS. Do we need to change catheter-related bloodstream infection surveillance in the Netherlands? A qualitative study among infection prevention professionals. BMJ Open 2021; 11:e046366. [PMID: 34408033 PMCID: PMC8375748 DOI: 10.1136/bmjopen-2020-046366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Catheter-related bloodstream infections (CRBSI) are a common healthcare-associated infection and therefore targeted by surveillance programmes in many countries. Concerns, however, have been voiced regarding the reliability and construct validity of CRBSI surveillance and the connection with the current diagnostic procedures. The aim of this study was to explore the experiences of infection control practitioners (ICPs) and medical professionals with the current CRBSI surveillance in the Netherlands and their suggestions for improvement. DESIGN Qualitative study using focus group discussions (FGDs) with ICPs and medical professionals separately, followed by semistructured interviews to investigate whether the points raised in the FGDs were recognised and confirmed by the interviewees. Analyses were performed using thematic analyses. SETTING Basic, teaching and academic hospitals in the Netherlands. PARTICIPANTS 24 ICPs and 9 medical professionals. RESULTS Main themes derived from experiences with current surveillance were (1) ICPs' doubt regarding the yield of surveillance given the low incidence of CRBSI, the high workload and IT problems; (2) the experienced lack of leadership and responsibility for recording information needed for surveillance and (3) difficulties with applying and interpreting the CRBSI definition. Suggestions were made to simplify the surveillance protocol, expand the follow-up and surveillance to homecare settings, simplify the definition and customise it for specific patient groups. Participants reported hoping for and counting on automatisation solutions to support future surveillance. CONCLUSIONS This study reveals several problems with the feasibility and acceptance of the current CRBSI surveillance and proposes several suggestions for improvement. This provides valuable input for future surveillance activities, thereby taking into account automation possibilities.
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Affiliation(s)
- Janneke Dm Verberk
- Medical Microbiology and Infection Control, UMC Utrecht, Utrecht, The Netherlands
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Tjallie Ii van der Kooi
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Lennie Pg Derde
- Department of Intensive Care Medicine, UMC Utrecht, Utrecht, The Netherlands
| | - Marc Jm Bonten
- Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands
| | - Sabine C de Greeff
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Maaike Sm van Mourik
- Medical Microbiology and Infection Control, UMC Utrecht, Utrecht, The Netherlands
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Haque M, McKimm J, Sartelli M, Dhingra S, Labricciosa FM, Islam S, Jahan D, Nusrat T, Chowdhury TS, Coccolini F, Iskandar K, Catena F, Charan J. Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview. Risk Manag Healthc Policy 2020; 13:1765-1780. [PMID: 33061710 PMCID: PMC7532064 DOI: 10.2147/rmhp.s269315] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/09/2020] [Indexed: 12/13/2022] Open
Abstract
Healthcare-associated infections (HCAIs) are a major source of morbidity and mortality and are the second most prevalent cause of death. Furthermore, it has been reported that for every one-hundred patients admitted to hospital, seven patients in high-income economies and ten in emerging and low-income economies acquire at least one type of HCAI. Currently, almost all pathogenic microorganisms have developed antimicrobial resistance, and few new antimicrobials are being developed and brought to market. The literature search for this narrative review was performed by searching bibliographic databases (including Google Scholar and PubMed) using the search terms: "Strategies," "Prevention," and "Healthcare-Associated Infections," followed by snowballing references cited by critical articles. We found that although hand hygiene is a centuries-old concept, it is still the primary strategy used around the world to prevent HCAIs. It forms one of a bundle of approaches used to clean and maintain a safe hospital environment and to stop the transmission of contagious and infectious microorganisms, including multidrug-resistant microbes. Finally, antibiotic stewardship also has a crucial role in reducing the impact of HCAIs through conserving currently available antimicrobials.
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Affiliation(s)
- Mainul Haque
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur57000, Malaysia
| | - Judy McKimm
- Medical Education, Swansea University School of Medicine, Grove Building, Swansea University, Swansea, WalesSA2 8PP, UK
| | - Massimo Sartelli
- Department of General and Emergency Surgery, Macerata Hospital, Macerata, Italy
| | - Sameer Dhingra
- School of Pharmacy, The University of the West Indies, St. Augustine Campus, Faculty of Medical Sciences, Eric Williams Medical Sciences Complex, Uriah Butler Highway, Trinidad & Tobago, West Indies
| | | | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka1342, Bangladesh
| | - Dilshad Jahan
- Department of Hematology, Asgar Ali Hospital, Dhaka1204, Bangladesh
| | - Tanzina Nusrat
- Department of Microbiology, Chittagong Medical College, Chattogram4203, Bangladesh
| | | | - Federico Coccolini
- Department of General Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Katia Iskandar
- School of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Troughton R, Mariano V, Campbell A, Hettiaratchy S, Holmes A, Birgand G. Understanding determinants of infection control practices in surgery: the role of shared ownership and team hierarchy. Antimicrob Resist Infect Control 2019; 8:116. [PMID: 31341614 PMCID: PMC6631607 DOI: 10.1186/s13756-019-0565-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 06/26/2019] [Indexed: 01/26/2023] Open
Abstract
Background Despite a large literature on surgical site infection (SSI), the determinants of prevention behaviours in surgery remain poorly studied. Understanding key social and contextual components of surgical staff behaviour may help to design and implement infection control (IC) improvement interventions in surgery. Methods Qualitative semi-structured interviews were conducted with surgeons (n = 8), nurses (n = 5) theatre personnel (n = 3), and other healthcare professionals involved in surgery (n = 4) in a 1500-bed acute care London hospital group. Participants were approached through established mailing lists and snowball sampling. Interviews were recorded and transcribed verbatim. Transcripts were coded and analysed thematically using a constant comparative approach. Results IC behaviour of surgical staff was governed by factors at individual, team, and wider hospital level. IC practices were linked to the perceived risk of harm caused by an SSI more than the development of an SSI alone. Many operating room participants saw SSI prevention as a team responsibility. The sense of ownership over SSI occurence was closely tied to how preventable staff perceived infections to be, with differences observed between clean and contaminated surgery. However, senior surgeons claimed personal accountability for rates despite feeling SSIs are often not preventable. Hierarchy impacted on behaviour in different ways depending on whether it was within or between professional categories. One particular knowledge gap highlighted was the lack of awareness regarding criteria for SSI diagnosis. Conclusions To influence IC behaviours in surgery, interventions need to consider the social team structure and shared ownership of the clinical outcome in order to increase the awareness in specialties where SSIs are not seen as serious complications. Electronic supplementary material The online version of this article (10.1186/s13756-019-0565-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rachael Troughton
- 1National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN UK
| | - Victor Mariano
- 1National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN UK
| | - Anne Campbell
- 1National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN UK
| | - Shehan Hettiaratchy
- Major Trauma Centre, St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY UK
| | - Alison Holmes
- 1National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN UK
| | - Gabriel Birgand
- 1National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN UK
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Ridelberg M, Roback K, Nilsen P, Carlfjord S. Patient safety work in Sweden: quantitative and qualitative analysis of annual patient safety reports. BMC Health Serv Res 2016; 16:98. [PMID: 27001079 PMCID: PMC4802598 DOI: 10.1186/s12913-016-1350-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 03/16/2016] [Indexed: 11/17/2022] Open
Abstract
Background There is widespread recognition of the problem of unsafe care and extensive efforts have been made over the last 15 years to improve patient safety. In Sweden, a new patient safety law obliges the 21 county councils to assemble a yearly patient safety report (PSR). The aim of this study was to describe the patient safety work carried out in Sweden by analysing the PSRs with regard to the structure, process and result elements reported, and to investigate the perceived usefulness of the PSRs as a tool to achieve improved patient safety. Methods The study was based on two sources of data: patient safety reports obtained from county councils in Sweden published in 2014 and a survey of health care practitioners with strategic positions in patient safety work, acting as key informants for their county councils. Answers to open-ended questions were analysed using conventional content analysis. Results A total of 14 structure elements, 31 process elements and 23 outcome elements were identified. The most frequently reported structure elements were groups devoted to working with antibiotics issues and electronic incident reporting systems. The PSRs were perceived to provide a structure for patient safety work, enhance the focus on patient safety and contribute to learning about patient safety. Conclusion Patient safety work carried out in Sweden, as described in annual PSRs, features a wide range of structure, process and result elements. According to health care practitioners with strategic positions in the county councils’ patient safety work, the PSRs are perceived as useful at various system levels. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1350-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mikaela Ridelberg
- Department of Medical and Health Sciences, Division of Health Care Analysis, Linköping University, SE-581 83, Linköping, Sweden
| | - Kerstin Roback
- Department of Medical and Health Sciences, Division of Health Care Analysis, Linköping University, SE-581 83, Linköping, Sweden
| | - Per Nilsen
- Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, SE-581 83, Linköping, Sweden
| | - Siw Carlfjord
- Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, SE-581 83, Linköping, Sweden.
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