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Ferlias N, Michelotti A, Stoustrup P. Patient safety in orthodontic care: a scoping literature review with proposal for terminology and future research agenda. BMC Oral Health 2024; 24:702. [PMID: 38890596 PMCID: PMC11184803 DOI: 10.1186/s12903-024-04375-7] [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: 03/11/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Knowledge about patient safety in orthodontics is scarce. Lack of standardisation and a common terminology hinders research and limits our understanding of the discipline. This study aims to 1) summarise current knowledge about patient safety incidents (PSI) in orthodontic care by conducting a systematic literature search, 2) propose a new standardisation of PSI terminology and 3) propose a future research agenda on patient safety in the field of orthodontics. METHODS A systematic literature search was performed in the main online sources of PubMed, Web of Science, Scopus and OpenGrey from their inception to 1 July 2023. Inclusion criteria were based on the World Health Organization´s (WHO) research cycle on patient safety. Studies providing information about the cycle's steps related to orthodontics were included. Study selection and data extraction were performed by two of the authors. RESULTS A total of 3,923 articles were retrieved. After review of titles and abstracts, 41 articles were selected for full-text review and 25 articles were eligible for inclusion. Seven provided information on the WHO's research cycle step 1 ("measuring harm"), twenty-one on "understanding causes" (step 2) and twelve on "identifying solutions" (step 3). No study provided information on Steps 4 and 5 ("evaluating impact" or "translating evidence into safer care"). CONCLUSION Current evidence on patient safety in orthodontics is scarce due to a lack of standardised reporting and probably also under-reporting of PSIs. Current literature on orthodontic patient safety deals primarily with "measuring harms" and "understanding causes of patient safety", whereas less attention has been devoted to initiatives "identifying solutions", "evaluating impact" and "translating evidence into safer care". The present project holds a proposal for a new categorisation, terminology and future research agenda that may serve as a framework to support future research and clinical initiatives to improve patient safety in orthodontic care. REGISTRATION PROSPERO (CRD42022371982).
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Affiliation(s)
- Nikolaos Ferlias
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
- Private Practice, Brighton, UK.
| | - Ambrosina Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
| | - Peter Stoustrup
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Ferlias N, Nielsen H, Andersen E, Stoustrup P. Lessons learnt on patient safety in dentistry through a 5-year nationwide database study on iatrogenic harm. Sci Rep 2024; 14:11436. [PMID: 38763944 PMCID: PMC11102909 DOI: 10.1038/s41598-024-62107-x] [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: 10/23/2023] [Accepted: 05/14/2024] [Indexed: 05/21/2024] Open
Abstract
Safe delivery of care is a priority in dentistry, while basic epidemiological knowledge of patient safety incidents is still lacking. The objectives of this study were to (1) classify patient safety incidents related to primary dental care in Denmark in the period 2016-2020 and study the distribution of different types of dental treatment categories where harm occurred, (2) clarify treatment categories leading to "nerve injury" and "tooth loss" and (3) assess the financial cost of patient-harm claims. Data from the Danish Dental Compensation Act (DDCA) database was retrieved from all filed cases from 1st January 2016 until 31st December 2020 pertaining to: (1) The reason why the patient applied for treatment-related harm compensation, (2) the event that led to the alleged harm (treatment category), (3) the type of patient-harm, and (4) the financial cost of all harm compensations. A total of 9069 claims were retrieved, of which 5079 (56%) were found eligible for compensation. The three most frequent categories leading to compensation were "Root canal treatment and post preparation"(n = 2461, 48% of all approved claims), "lack of timely diagnosis and initiation of treatment" (n = 905, 18%) and "surgery" (n = 878, 17%). Damage to the root of the tooth accounted for more than half of all approved claims (54.36%), which was most frequently a result of either parietal perforation during endodontic treatment (18.54%) or instrument fracture (18.89%). Nerve injury accounted for 16.81% of the approved claims. Total cost of all compensation payments was €16,309,310, 41.1% of which was related to surgery (€6,707,430) and 20.4% (€3,322,927) to endodontic treatment. This comprehensive analysis documents that harm permeates all aspects of dentistry, especially in endodontics and surgery. Neglect or diagnostic delays contribute to 18% of claims, indicating that harm does not solely result from direct treatment. Treatment harm inflicts considerable societal costs.
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Affiliation(s)
- Nikolaos Ferlias
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, 8000, Aarhus, Denmark.
| | - Henrik Nielsen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Erik Andersen
- Private Practice, Colosseum Dental Group, Broendby, Copenhagen, Denmark
| | - Peter Stoustrup
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, 8000, Aarhus, Denmark
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Padmanabhan V, Islam MS, Rahman MM, Chaitanya NC, Sivan PP. Understanding patient safety in dentistry: evaluating the present and envisioning the future-a narrative review. BMJ Open Qual 2024; 13:e002502. [PMID: 38719522 PMCID: PMC11086509 DOI: 10.1136/bmjoq-2023-002502] [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] [Accepted: 10/26/2023] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Patient safety is crucial in dentistry, yet it has received delayed recognition compared with other healthcare fields. This literature review assesses the current state of patient safety in dentistry, investigates the reasons for the delay, and offers recommendations for enhancing patient safety in dental practices, dental schools, and hospitals. METHODS The review incorporates a thorough analysis of existing literature on patient safety in dentistry. Various sources, including research articles, guidelines and reports, were reviewed to gather insights into patient safety definitions, challenges and best practices specific to dentistry. RESULTS The review underscores the importance of prioritising patient safety in dentistry at all levels of healthcare. It identifies key definitions and factors contributing to the delayed focus on patient safety in the field. Additionally, it emphasises the significance of establishing a patient safety culture and discusses approaches such as safety plans, incident management systems, blame-free cultures and ethical frameworks to enhance patient safety. CONCLUSION Patient safety is vital in dentistry to ensure high-quality care and patient well-being. The review emphasises the importance of prioritising patient safety in dental practices, dental schools and hospitals. Through the implementation of recommended strategies and best practices, dental organisations can cultivate a patient safety culture, enhance communication, mitigate risks and continually improve patient safety outcomes. The dissemination of knowledge and the active involvement of all stakeholders are crucial for promoting patient safety and establishing a safe dental healthcare system.
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Affiliation(s)
- Vivek Padmanabhan
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE
| | - Md Sofiqul Islam
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE
| | | | - Nallan Csk Chaitanya
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE
| | - Padma Priya Sivan
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE
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Saeed MHB, Raja UB, Khan Y, Gidman J, Niazi M. Interplay between leadership and patient safety in dentistry: a dental hospital-based cross-sectional study. BMJ Open Qual 2024; 13:e002376. [PMID: 38719526 PMCID: PMC11086432 DOI: 10.1136/bmjoq-2023-002376] [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: 04/18/2023] [Accepted: 12/19/2023] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES The study aimed to study the association of leadership practices and patient safety culture in a dental hospital. DESIGN Hospital-based, cross-sectional study SETTING: Riphah Dental Hospital (RDH), Islamabad, Pakistan. PARTICIPANTS All dentists working at RDH were invited to participate. MAIN OUTCOME MEASURES A questionnaire comprised of the Transformational Leadership Scale (TLS) and the Dental adapted version of the Medical Office Survey of Patient Safety Culture (DMOSOPS) was distributed among the participants. The response rates for each dimension were calculated. The positive responses were added to calculate scores for each of the patient safety and leadership dimensions and the Total Leadership Score (TLS) and total patient safety score (TPSS). Correlational analysis is performed to assess any associations. RESULTS A total of 104 dentists participated in the study. A high positive response was observed on three of the leadership dimensions: inspirational communication (85.25%), intellectual stimulation (86%), and supportive leadership (75.17%). A low positive response was found on the following items: 'acknowledges improvement in my quality of work' (19%) and 'has a clear sense of where he/she wants our unit to be in 5 years' (35.64%). The reported positive responses in the patient safety dimensions were high on three of the patient safety dimensions: organisational learning (78.41%), teamwork (82.91%), and patient care tracking/follow-up (77.05%); and low on work pressure and pace (32.02%). A moderately positive correlation was found between TLS and TPSS (r=0.455, p<0.001). CONCLUSIONS Leadership was found to be associated with patient safety culture in a dental hospital. Leadership training programmes should be incorporated during dental training to prepare future leaders who can inspire a positive patient safety culture.
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Affiliation(s)
- Muhammad Humza Bin Saeed
- Community Dentistry, Riphah International University, Islamabad, Pakistan
- Research, Development & Grants, NHS North Bristol Trust, Bristol, Bristol, UK
| | | | - Yawar Khan
- Riphah International University Faculty of Health and Medical Sciences, Islamabad, Pakistan
| | - Janice Gidman
- University of Chester, Chester, Cheshire West and Chester, UK
| | - Manahil Niazi
- Community Dentistry, Riphah International University, Islamabad, Pakistan
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Ensaldo-Carrasco E, Álvarez-Hernandez LA, Peralta-Pedrero ML, Aceves-González C. Patient safety climate research in primary care dentistry: A systematic scoping review. J Public Health Dent 2024. [PMID: 38679565 DOI: 10.1111/jphd.12621] [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: 11/14/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Patient safety climate constitutes an important element for quality improvement. Its current evidence base has been generated in hospital settings in developed countries. Studies in dentistry are limited. OBJECTIVE To systematically explore the evidence regarding assessing patient safety climate in dentistry. METHODS We developed a search strategy to explore MEDLINE, SCOPUS, and Web of Science databases from January 1st, 2002, to December 31st, 2022, to include observational studies on patient safety culture or patient safety climate assessment. Methodological features and item data concerning the dimensions employed for assessment were extracted and thematically analyzed. Reported scores were also collected. RESULTS Nine articles out of 5584 were included in this study. Most studies were generated from high-income economies. Our analysis revealed methodological variations. Non-randomized samples were employed (ranging from 139 to 656 participants), and response rates varied from 28% to 93.7%. Three types of measurement instruments have been adapted to assess patient safety climate. These mainly consisted of replacing words or rewording sentences. Only one study employed an instrument previously validated through psychometric methods. In general, patient safety climate levels were either low or neutral. Only one study reported scores equal to or greater than 75. DISCUSSION Despite diverse assessment tools, our two-decade analysis reveals a lag compared with medicine, resulting in methodological variations for assessing patient safety climate. Collaboration is vital to elevate standards, prioritize patient safety across oral healthcare services, and advocate for integrating safety climate into local and national quality and patient safety strategies.
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Affiliation(s)
| | | | | | - Carlos Aceves-González
- Centro de Investigaciones de Ergonomía, University of Guadalajara, Jalisco, Mexico
- School of Psychology, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
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Obadan-Udoh E, Sundararajan V, Sanchez GA, Howard R, Chandrupatla S, Worley D. Dental patients as partners in promoting quality and safety: a qualitative exploratory study. BMC Oral Health 2024; 24:438. [PMID: 38600495 PMCID: PMC11005277 DOI: 10.1186/s12903-024-04030-1] [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: 08/14/2023] [Accepted: 02/14/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE Active patient involvement in promoting quality and safety is a priority for healthcare. We investigated how dental patients perceive their role as partners in promoting quality and safety across various dental care settings. METHODS Focus group sessions were conducted at three dental practice settings: an academic dental center, a community dental clinic, and a large group private practice, from October 2018-July 2019. Patients were recruited through flyers or word-of-mouth invitations. Each session lasted 2.5 h and patients completed a demographic and informational survey at the beginning. Audio recordings were transcribed, and a hybrid thematic analysis was performed by two independent reviewers using Dedoose. RESULTS Forty-seven participants took part in eight focus group sessions; 70.2% were females and 38.3% were aged 45-64 years. Results were organized into three major themes: patients' overall perception of dental quality and safety; patients' reaction to an adverse dental event; and patients' role in promoting quality and safety. Dental patients were willing to participate in promoting quality and safety by careful provider selection, shared decision-making, self-advocacy, and providing post-treatment provider evaluations. Their reactions towards adverse dental events varied based on the type of dental practice setting. Some factors that influenced a patient's overall perception of dental quality and safety included provider credentials, communication skills, cleanliness, and durability of dental treatment. CONCLUSION The type of dental practice setting affected patients' desire to work as partners in promoting dental quality and safety. Although patients acknowledged having an important role to play in their care, their willingness to participate depended on their relationship with their provider and their perception of provider receptivity to patient feedback.
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Affiliation(s)
- Enihomo Obadan-Udoh
- Department of Preventive and Restorative Dental Sciences, University of California San Francisco, School of Dentistry, 707 Parnassus Avenue, D3214, Box #1361, San Francisco, CA, 94143, USA.
| | - Vyshiali Sundararajan
- Department of Preventive and Restorative Dental Sciences, University of California San Francisco, School of Dentistry, 707 Parnassus Avenue, D3214, Box #1361, San Francisco, CA, 94143, USA
| | - Gustavo A Sanchez
- Department of Preventive and Restorative Dental Sciences, University of California San Francisco, School of Dentistry, 707 Parnassus Avenue, D3214, Box #1361, San Francisco, CA, 94143, USA
| | - Rachel Howard
- Department of Preventive and Restorative Dental Sciences, University of California San Francisco, School of Dentistry, 707 Parnassus Avenue, D3214, Box #1361, San Francisco, CA, 94143, USA
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Rocchettta D, Hassan SS, Gray J. Dentists' Attitudes to the Preprocedural Safety Checklist "Time-Out" in Saudi Arabia. J Patient Saf 2024; 20:85-90. [PMID: 38038690 DOI: 10.1097/pts.0000000000001186] [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: 12/02/2023]
Abstract
OBJECTIVES Before performing medical procedures, there is a patient safety initiative process (also referred to as "time-out"), part of this process is the use of a preprocedural safety checklist. This initiative was envisioned by the World Health Organization, supported by various accreditation bodies who include the process in their standards. Dentistry lags behind its medical colleagues in using it presurgical or invasive procedure. Our aim was to understand dentists' attitudes and knowledge about the process and their adherence to it. METHODS A cross-sectional questionnaire was distributed between September and December 2021 and 102 dentists responded. RESULTS Seventy three of the respondents (71.5%) claimed to be familiar with the time-out process, and 87 (85.3%) felt that it was an important or somewhat important process; however, only 62 (60.7%) were always performing the process before surgical or invasive outpatient procedures. CONCLUSIONS Patient safety must be given priority, as such it has been shown that preprocedural checklists help reduce medical errors. Recognizing the value of performing such a process, accreditation bodies have included the process in their standards and indeed in the Joint Commission focused patient safety goals.
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Affiliation(s)
- Davide Rocchettta
- From the Dentistry Administration, King Fahad Medical City, Riyadh, Saudi Arabia
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Arbianti K, Amalia R, Hendrartini J, Kuntjoro T. Patient Safety Culture Analysis in Dental Hospital Using Dental Office Survey on Patient Safety Culture Questionnaire: A Cross-cultural Adaptation and Validation Study. J Patient Saf 2023; 19:429-438. [PMID: 37615483 DOI: 10.1097/pts.0000000000001153] [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: 08/25/2023]
Abstract
BACKGROUND The culture of safety and patient safety management in dental practice lags compared with medical practice. Hospitals strive to pursue quality and safety of healthcare services, with evidence of patient safety incidents in medical practice demonstrating the importance of promoting a safety culture. Measuring patient safety culture is a necessary first step to improving safety culture in clinical settings. As a hospital, dental hospital should improve the quality and culture of patient safety. Thus, our objective was to conduct a cross-cultural adaptation of a US measure of dental office patient safety culture for use in Indonesian dental hospitals. METHOD A cross-sectional study was conducted on 200 respondents at a dental hospital in Java, Indonesia. The first stage includes cultural adaptation and translation, followed by developing a questionnaire that was tested through expert agreement and analysis of validity and reliability using Spearman, Cronbach correlation coefficients, and correlation coefficients between classes. The Dental Office Survey on Patient Safety Culture consists of 58 items and 10 dimensions (overall perceptions of patient safety and quality, organizational learning, teamwork, staff training, work pressure and pace, management support for patient safety, office processes and standardization, communication about errors, communication openness, and patient care tracking/follow-up). RESULTS A total of 200 respondents with a response rate of 61.5% and 77 invalid responses due to incomplete filling, so 123 respondents were analyzed. The validity test results on 38 question items from 10 dimensions, with a sign of 0.05%, 35 items are declared valid. CONCLUSIONS The Indonesian version of the Dental Office Survey on Patient Safety Culture shows good validity and good reliability and has the potential to be used to evaluate patient safety culture in dental hospitals in Indonesia.
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Affiliation(s)
| | - Rosa Amalia
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Universitas Gadjah Mada
| | - Julita Hendrartini
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Universitas Gadjah Mada
| | - Tjahjono Kuntjoro
- Health Policy and Management Master and Doctoral Programme, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Briggs EA, Toner R, Kilgariff JK. Evidence-based Standard Operating Procedures FoR the Prevention and Management of Sodium Hypochlorite Accidents in Dentistry. Prim Dent J 2023; 12:97-109. [PMID: 36916617 DOI: 10.1177/20501684231155784] [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: 03/15/2023]
Abstract
This article aims to reduce harm and improve patient safety in dentistry by providing evidence-based guidance on the prevention, recognition, management, and reporting of sodium hypochlorite injuries occurring in the course of endodontic dental treatment. In contrast to previous publications all types of sodium hypochlorite harm and near-harm events in the dental setting are considered, to offer the reader an all-encompassing clinical guide for reference.
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la Encina ACD, Martínez-Rodríguez N, Ortega-Aranegui R, Cortes-Bretón Brinkmann J, Martínez-González JM, Barona-Dorado C. Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography. Int J Implant Dent 2022; 8:59. [PMID: 36441355 PMCID: PMC9705638 DOI: 10.1186/s40729-022-00459-7] [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: 07/09/2022] [Accepted: 11/12/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study used cone-beam computed tomography (CBCT) to analyze the prevalence of several maxillary anatomical/accessory structures, as well as variations within each type, assessing how accurate diagnosis can minimize the risk of intraoperative complications during implantological procedures in the oral cavity. METHODS 212 CBCT scans of the maxilla were analyzed, captured over a period of 18 months for surgical planning purposes. The prevalence of posterior superior alveolar arteries (PSAA), maxillary sinus septa (MSS), and branches of the canalis sinuosus (CS) were evaluated, as were the diameter and location of each anatomical structure in horizontal and vertical planes. P < 0.05 was considered statistically significant. RESULTS PSAAs were observed in 99.1% of cases, the intrasinus type being the most frequent; MSS were noted in 15.6% of the sample, mainly in the posterior region with sagittal orientation; CS branches were observed in 50% of patients, mainly in relation to the incisors and significantly more prevalent among males. CONCLUSIONS The use of CBCT significantly increases the possibility of clearly identifying these anatomical structures. The differences found between patients highlight the importance of carrying out an exhaustive radiological study of the individual to prevent complications, such as Schneiderian membrane perforation, neurovascular damage or bleeding during surgery.
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Affiliation(s)
- Augusto Cimolai-de la Encina
- grid.4795.f0000 0001 2157 7667Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Natalia Martínez-Rodríguez
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
| | - Ricardo Ortega-Aranegui
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain
| | - Jorge Cortes-Bretón Brinkmann
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
| | - José María Martínez-González
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
| | - Cristina Barona-Dorado
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
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Blanchard JR, Koshal S, Navaratnam A, Machin JT, Briggs TWR, Jones E. Hospital dentistry litigation in England: clinical negligence claims against the NHS 2015-2020. Br Dent J 2022:10.1038/s41415-022-4965-4. [PMID: 36068267 DOI: 10.1038/s41415-022-4965-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/09/2022] [Indexed: 11/08/2022]
Abstract
Introduction Litigation against the NHS in England is rising. The aim of this study was to determine the incidence and characteristics of hospital dentistry clinical negligence claims in England.Methods A retrospective review was undertaken of all clinical negligence claims in England held by NHS Resolution relating to hospital dentistry between April 2015 and April 2020. Analysis was performed using the information for cause, patient injury and claim cost.Results A total of 492 claims were identified, with an estimated potential cost of £14 million. The most frequent causes for clinical negligence claims included failure/delay in treatment (n = 175; £3.9 million), inappropriate treatment (n = 56; £1.8 million) and failure to warn/obtain informed consent (n = 37; £1.5 million). Wrong site surgery was cited in 33 claims. The most frequent injury reported was dental damage (n = 197; £4.3 million), unnecessary pain (n = 125; £2.3 million) and nerve damage (n = 52; £2.4 million).Conclusion Clinical negligence claims in hospital dentistry are related to several different aspects of patient management and are not limited to treatment complications alone. Human ergonomics and patient perception of dentistry cannot be controlled but a focus on patient safety measures and effective communication can serve as tools to combat these factors.
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Affiliation(s)
- Jessica R Blanchard
- Department of Oral Surgery, Royal National ENT and Eastman Dental Hospitals, University College London Hospitals, 47-49 Huntley Street, London, WC1E 6DG, UK.
| | - Sonita Koshal
- Department of Oral Surgery, Royal National ENT and Eastman Dental Hospitals, University College London Hospitals, 47-49 Huntley Street, London, WC1E 6DG, UK
| | - Annakan Navaratnam
- Royal National ENT and Eastman Dental Hospitals, UCLH, 47-49 Huntley Street, London, WC1E 6DG, UK; Getting it Right First Time Programme, NHS England and Improvement, Wellington House, 135-155 Waterloo Road, London, SE1 8UG, UK
| | - John T Machin
- NHS England and Improvement, Wellington House, 135-155 Waterloo Road, London, SE1 8UG, UK
| | - Tim W R Briggs
- NHS England and Improvement, Wellington House, 135-155 Waterloo Road, London, SE1 8UG, UK
| | - Elizabeth Jones
- Getting it Right First Time Programme, NHS England and Improvement, Wellington House, 135-155 Waterloo Road, London, SE1 8UG, UK
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Surgical safety checklists for dental implant surgeries-a scoping review. Clin Oral Investig 2022; 26:6469-6477. [PMID: 36028779 DOI: 10.1007/s00784-022-04698-1] [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: 05/11/2022] [Accepted: 08/21/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES In both elective surgeries and aviation, a reduction of complications can be expected by paying attention to the so-called human factors. Checklists are a well-known way to overcome some of these problems. We aimed to evaluate the current evidence regarding the use of checklists in implant dentistry. METHODS An electronic literature search was conducted in the following databases: CINHAL, Medline, Web of Science, and Cochrane Library until March 2022. Based on the results and additional literature, a preliminary checklist for surgical implant therapy was designed. RESULTS Three publications dealing with dental implants and checklists were identified. One dealt with the use of a checklist in implant dentistry and was described as a quality assessment study. The remaining two studies offered suggestions for checklists based on literature research and expert opinion. CONCLUSIONS Based on our results, the evidence for the use of checklists in dental implantology is extremely low. Considering the great potential, it can be stated that there is a need to catch up. While creating a new implant checklist, we took care of meeting the criteria for high-quality checklists. Future controlled studies will help to place it on a broad foundation. CLINICAL RELEVANCE Checklists are a well-known way to prevent complications. They are especially established in aviation, but many surgical specialties and anesthesia adopt this successful concept. As implantology has become one of the fastest-growing areas of dentistry, it is imperative that checklists become an integral part of it.
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Juliawati M, Darwita RR, Adiatman M, Lestari F. Patient Safety Culture in Dentistry Analysis Using the Safety Attitude Questionnaire in DKI Jakarta, Indonesia: A Cross-Cultural Adaptation and Validation Study. J Patient Saf 2022; 18:486-493. [PMID: 35121721 PMCID: PMC9329039 DOI: 10.1097/pts.0000000000000980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to analyze a cross-cultural adaptation of the Safety Attitude Questionnaire (SAQ) for Indonesian dentists. METHODS A cross-sectional study was conducted on 250 general dentists in health services in Jakarta, Indonesia. The first step included cultural adaptation and translation, which was followed by the development of the tested questionnaire through expert agreement and by validity and reliability analysis using Spearman correlation coefficient, Cronbach α , and interclass correlation coefficient. The SAQ consisted of 30 items and 6 dimensions (safety climate, teamwork climate, job satisfaction, stress recognition, perception of management, and working conditions).Respondents were members of the Indonesian Dental Association who voluntarily filled out a Google-based questionnaire from September to October 2020. RESULTS A total of 250 respondents with a response rate of 16.4% demonstrated a total Cronbach α value of 0.897, whereas the value per item ranged from 0.890 to 0.905, which suggested an acceptable and good to very good internal consistency. The interclass correlation coefficient value varied from 0.840 to 1.000, which meant almost perfect agreement. The correlation coefficient of 30 questions items resulted in a total SAQ score ranging from 0.422 to 0.699 (moderate to strong correlation) and between 6 dimensions to total SAQ score ranging from 0.648 to 0.772 (strong correlation). CONCLUSIONS The Indonesian version of the SAQ exhibited good validity and very good reliability and potential to be used for evaluating dentists' patient safety culture in Indonesia.
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Affiliation(s)
- Mita Juliawati
- From the Graduate School, Doctoral Study Programme, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Risqa R. Darwita
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Universitas, Indonesia, Jakarta, Indonesia
| | - Melissa Adiatman
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Universitas, Indonesia, Jakarta, Indonesia
| | - Fatma Lestari
- Occupational Health and Safety Department, Faculty of Public Health, Universitas Indonesia, Depok Indonesia
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Chohan P, Renton T, Wong J, Bailey E. Patient safety in dentistry - the bigger picture. Br Dent J 2022; 232:460-469. [PMID: 35396430 DOI: 10.1038/s41415-022-4095-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 08/09/2021] [Indexed: 11/09/2022]
Abstract
Background Patient safety incidents (PSIs) have recently become a topic of discussion within dentistry. NHS England data has highlighted that wrong tooth extraction is the most common surgical Never Event (NE); however, this data reflects mainly a secondary care picture. Consideration needs to be given to reporting of PSIs occurring in primary care.Aims To establish the current attitudes of both primary and secondary care dentists within this field and to use this to promote a positive, supportive culture.Methods A national electronic survey was sent to dentists for data capture related to this topic, from April to September 2019 inclusively.Results There were 104 responses to the survey. Responses included that 39% of responders were general dental practitioners (GDPs), 90% were aware of NEs, 48% were not aware of how to report PSIs and 74% of dentists felt that fear of the General Dental Council/Care Quality Commission repercussions was a barrier to them reporting PSIs. Additionally, 86% of dentists felt that a trainee/GDP support network would be useful to share learning regarding PSIs.Conclusion The survey results highlighted that there is a lack of knowledge concerning PSI reporting, combined with a culture of fear of the repercussions of reporting. The survey data will aim to be used to implement a supportive network for dentists, develop a positive ethos surrounding PSIs and optimise patient care.
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Affiliation(s)
- Priya Chohan
- Oral Surgery Speciality Registrar ST1, Bradford Teaching Hospitals Foundation Trust, Bradford, UK.
| | - Tara Renton
- Professor in Oral Surgery and Honorary Consultant, King´s College Hospital Foundation Trust and Guy´s and St Thomas´ Foundation Trust, London, UK
| | - Jason Wong
- Deputy Chief Dental Officer England, Office of Chief Dental Officer, The Maltings Dental Practice, Grantham, Lincolnshire, UK
| | - Edmund Bailey
- Senior Clinical Lecturer and Honorary Consultant in Oral Surgery, Department of Oral Surgery, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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15
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Never events in clinical orthodontic practice. Am J Orthod Dentofacial Orthop 2022; 161:480-489. [DOI: 10.1016/j.ajodo.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 11/17/2022]
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Obadan-Udoh EM, Gharpure A, Lee JH, Pang J, Nayudu A. Perspectives of Dental Patients About Safety Incident Reporting: A Qualitative Pilot Study. J Patient Saf 2021; 17:e874-e882. [PMID: 34009866 DOI: 10.1097/pts.0000000000000863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Patient reporting of safety incidents is one of the hallmarks of an effective patient safety protocol in any health care setting. However, very little is known about safety reporting among dental patients or effective strategies for engaging them in activities that promote safety. The goal of this study was to understand the perceptions of dental patients about the barriers and benefits of reporting safety incidents. We also sought to identify strategies for improving patient reporting of safety incidents in the dental care setting. METHODS We conducted 3 focus group sessions with adult dental patients (n = 16) attending an academic dental center from November 2017 to February 2018. Audio recordings were transcribed and analyzed using a hybrid thematic analysis approach with NVivo software. RESULTS Dental patients mainly attributed safety incidents to provider-related and systemic factors. They were most concerned about the financial implications, inconvenience of multiple visits, and the absence of an apology when an incident occurred. The major recommended strategies for engaging patients in safety-related activities included the following: proactive solicitation of patient feedback, what-to-expect checklists, continuous communication during visits/procedures, after-visit summary reports, clear incident reporting protocols, use of technology, independent third-party safety incident reporting platforms, and a closed feedback loop. CONCLUSIONS This study offers a roadmap for proactively working with dental patients as vigilant partners in promoting quality and safety. If properly engaged, dental patients are prepared to work with dental professionals to identify threats to safety and reduce the occurrence of harm.
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Affiliation(s)
- Enihomo M Obadan-Udoh
- From the Department of Preventive and Restorative Dental Sciences, University of California San Francisco (UCSF) School of Dentistry, San Francisco, California
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Ensaldo-Carrasco E, Sheikh A, Cresswell K, Bedi R, Carson-Stevens A, Sheikh A. Patient Safety Incidents in Primary Care Dentistry in England and Wales: A Mixed-Methods Study. J Patient Saf 2021; 17:e1383-e1393. [PMID: 34852417 DOI: 10.1097/pts.0000000000000530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In recent decades, there has been considerable international attention aimed at improving the safety of hospital care, and more recently, this attention has broadened to include primary medical care. In contrast, the safety profile of primary care dentistry remains poorly characterized. OBJECTIVES We aimed to describe the types of primary care dental patient safety incidents reported within a national incident reporting database and understand their contributory factors and consequences. METHODS We undertook a cross-sectional mixed-methods study, which involved analysis of a weighted randomized sample of the most severe incident reports from primary care dentistry submitted to England and Wales' National Reporting and Learning System. Drawing on a conceptual literature-derived model of patient safety threats that we previously developed, we developed coding frameworks to describe and conduct thematic analysis of free text incident reports and determine the relationship between incident types, contributory factors, and outcomes. RESULTS Of 2000 reports sampled, 1456 were eligible for analysis. Sixty types of incidents were identified and organized across preoperative (40.3%, n = 587), intraoperative (56.1%, n = 817), and postoperative (3.6%, n = 52) stages. The main sources of unsafe care were delays in treatment (344/1456, 23.6%), procedural errors (excluding wrong-tooth extraction) (227/1456; 15.6%), medication-related adverse incidents (161/1456, 11.1%), equipment failure (90/1456, 6.2%) and x-ray related errors (87/1456, 6.0%). Of all incidents that resulted in a harmful outcome (n = 77, 5.3%), more than half were due to wrong tooth extractions (37/77, 48.1%) mainly resulting from distraction of the dentist. As a result of this type of incident, 34 of the 37 patients (91.9%) examined required further unnecessary procedures. CONCLUSIONS Flaws in administrative processes need improvement because they are the main cause for patients experiencing delays in receiving treatment. Checklists and standardization of clinical procedures have the potential to reduce procedural errors and avoid overuse of services. Wrong-tooth extractions should be addressed through focused research initiatives and encouraging policy development to mandate learning from serious dental errors like never events.
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Affiliation(s)
- Eduardo Ensaldo-Carrasco
- From the Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh
| | - Asiyah Sheikh
- College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, Scotland
| | - Kathrin Cresswell
- From the Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh
| | - Raman Bedi
- King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, Division of Population and Patient Health, King's College London, United Kingdom
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Dargue A, Fyfe E, French K, Ali K, Bailey E, Bell A, Bolt R, Bulsara Y, Carey J, Emanuel C, Green R, Khawaja N, Kushnerev E, Patel N, Shepherd S, Smart B, Smyth J, Taylor K, Varma Datla K. The impact of wrong-site surgery on dental undergraduate teaching: a survey of UK dental schools. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:670-678. [PMID: 33315279 DOI: 10.1111/eje.12645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Patient safety within dental education is paramount. Wrong-site surgery (WSS) tooth extraction is not uncommon and is a significant never event (NE) in dentistry. This study aimed to explore dental schools' undergraduate experience of NEs, safety interventions implemented and the impact on student experience. METHODS All 16 UK dental schools were surveyed via email. RESULTS The response rate was 100%. A modified World Health Organization (WHO) checklist was used within institutions (94%) including pre-operative briefings and recording teeth on whiteboards (81%, respectively). Students were directly supervised performing extractions (63%) utilising a 1:4 staff: student ratio. WSS by students was reported in 69% of schools, with student experience being impacted by an increased patient safety focus. DISCUSSION This study demonstrated an increased utilisation of an adapted WHO checklist. Modification of practices to ensure patient safety was demonstrated at all schools, irrespective of student WSS occurrences. Institutions experiencing student NEs commonly implemented WHO checklists and recording teeth for extraction on whiteboards. Other strategies included direct staff supervision and pre-operative briefings. CONCLUSION UK dental schools have increased the emphasis on patient safety by the implementation of national healthcare models, for example WHO checklists and pre-operative briefings. These strategies both aim to improve communication and teamwork. Increased levels of staff supervision foster greater quality of teaching; however, this has resulted in reduced student clinical experience. A proposed minimum standard for undergraduate surgery is suggested to ensure safe and competent dental practitioners of the future.
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Affiliation(s)
- Anna Dargue
- University of Bristol Dental Hospital, Bristol, UK
| | - Eithne Fyfe
- University of Bristol Dental Hospital, Bristol, UK
| | | | - Kamran Ali
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Edmund Bailey
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aileen Bell
- University of Glasgow Dental Hospital and School, Glasgow, UK
| | - Robert Bolt
- University of Sheffield Dental School, Sheffield, UK
| | - Yogesh Bulsara
- School of Dentistry, University of Birmingham, Birmingham, UK
| | - James Carey
- University of Leeds School of Dentistry, Leeds, UK
| | | | - Rachel Green
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Nadine Khawaja
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | | | - Neil Patel
- Division of Dentistry, University of Manchester, Manchester, UK
| | - Simon Shepherd
- University of Dundee Dental Hospital and School, Dundee, UK
| | - Binthan Smart
- Institute of Dentistry, University of Aberdeen, Aberdeen, UK
| | - Joanna Smyth
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Kate Taylor
- School of Dentistry, University of Liverpool, Liverpool, UK
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Jones A, Stagnell S, Renton T, Aggarwal VR, Moore R. Causes of subcutaneous emphysema following dental procedures: a systematic review of cases 1993-2020. Br Dent J 2021; 231:493-500. [PMID: 34686817 DOI: 10.1038/s41415-021-3564-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/08/2021] [Indexed: 11/09/2022]
Abstract
Objectives Causes of subcutaneous emphysema (SE) following dental treatment have changed with new operative techniques and equipment. This review demonstrates the frequency and aetiology of SE to inform prevention strategies for reducing SE occurrences.Methods A systematic search of Medline, Embase and PubMed databases identified 135 cases of SE which met inclusion criteria after independent review by two authors. Trends in frequency and causes of SE were displayed graphically and significant differences in frequency of SE by time period, site and hospital stay were analysed using t-tests.Results Dental extractions often preceded development of SE (54% of cases), commonly surgical extractions. Treatment of posterior mandibular teeth most often resulted in development of SE. Most cases were iatrogenic, with 51% resulting from an air-driven handpiece and 9% from air syringes. Factors such as nose blowing accounted for 10%. There was a significant (p <0.05) increase in cases over time. Mandibular teeth had increased hospital stay time compared to maxillary teeth (p <0.01).Conclusion Increased risks of SE were identified following use of air-driven handpieces during dental extractions and when treating lower molar teeth. Use of air-driven handpieces should be avoided during dental extractions to reduce risks and subsequent morbidity that results from SE.
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Affiliation(s)
- Adam Jones
- Department of Oral Surgery, University of Leeds, UK.
| | | | - Tara Renton
- Department of Oral Surgery, King´s College London, UK
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Jacob O, Gough E, Thomas H. Preventing Wrong Tooth Extraction. Acta Stomatol Croat 2021; 55:316-324. [PMID: 34658378 PMCID: PMC8514230 DOI: 10.15644/asc55/3/9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022] Open
Abstract
Objective of Work Wrong-site tooth extraction (WSTE) is the most common serious patient safety incident in dentistry. Safety checklists have significantly reduced wrong-site surgery, although their benefit is unproven in primary care dentistry. Our quality improvement project developed and implemented a checklist optimised for oral surgery procedures in primary care to reduce WSTE risk. Material and Methods Local best practice for tooth extraction record-keeping (LBP), using national guidelines and standards was devised. We then retrospectively audited tooth extraction record-keeping against LBP. Deficiencies in current record-keeping practice were identified and used to design a checklist aimed at improving compliance. We provided a computerised safety checklist compliant with LBP to eleven clinicians at three general dental clinics within our region. The checklist included a pre-operative safety check, a pause to re-confirm the surgical site and a post-operative record-keeping proforma. The checklist was linked to our record-keeping software for use during tooth extraction. We audited checklist completion and compliance with LBP fortnightly for ten weeks. Results The introduction of a safety checklist resulted in increased compliance with LBP for tooth extraction record keeping. At week ten, 67% of records contained the computerised safety checklist. This resulted in a 50% increase in overall compliance with LBP for tooth extraction compared to baseline. Conclusions A computerised safety checklist for tooth extraction in primary care has potential to improve patient safety by adopting measures to prevent WSTE and standardising communication between clinicians. Checklists in general practice should be encouraged.
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Affiliation(s)
- Oliver Jacob
- Department of Dentistry, Powys Teaching Health Board, United Kingdom
| | - Evelyn Gough
- Department of Dentistry, Powys Teaching Health Board, United Kingdom
| | - Heidi Thomas
- Department of Dentistry, Powys Teaching Health Board, United Kingdom
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Kalenderian E, Obadan-Udoh E, Maramaldi P, Etolue J, Yansane A, Stewart D, White J, Vaderhobli R, Kent K, Hebballi NB, Delattre V, Kahn M, Tokede O, Ramoni RB, Walji MF. Classifying Adverse Events in the Dental Office. J Patient Saf 2021; 17:e540-e556. [PMID: 28671915 PMCID: PMC5748012 DOI: 10.1097/pts.0000000000000407] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dentists strive to provide safe and effective oral healthcare. However, some patients may encounter an adverse event (AE) defined as "unnecessary harm due to dental treatment." In this research, we propose and evaluate two systems for categorizing the type and severity of AEs encountered at the dental office. METHODS Several existing medical AE type and severity classification systems were reviewed and adapted for dentistry. Using data collected in previous work, two initial dental AE type and severity classification systems were developed. Eight independent reviewers performed focused chart reviews, and AEs identified were used to evaluate and modify these newly developed classifications. RESULTS A total of 958 charts were independently reviewed. Among the reviewed charts, 118 prospective AEs were found and 101 (85.6%) were verified as AEs through a consensus process. At the end of the study, a final AE type classification comprising 12 categories, and an AE severity classification comprising 7 categories emerged. Pain and infection were the most common AE types representing 73% of the cases reviewed (56% and 17%, respectively) and 88% were found to cause temporary, moderate to severe harm to the patient. CONCLUSIONS Adverse events found during the chart review process were successfully classified using the novel dental AE type and severity classifications. Understanding the type of AEs and their severity are important steps if we are to learn from and prevent patient harm in the dental office.
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Affiliation(s)
| | | | | | - Jini Etolue
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Alfa Yansane
- University of California, San Francisco, School of Dentistry, CA, USA
| | - Denice Stewart
- Oregon Health & Science University, School of Dentistry, Portland, OR, USA
| | - Joel White
- University of California, San Francisco, School of Dentistry, CA, USA
| | - Ram Vaderhobli
- University of California, San Francisco, School of Dentistry, CA, USA
| | - Karla Kent
- Oregon Health & Science University, School of Dentistry, Portland, OR, USA
| | - Nutan B. Hebballi
- University of Texas Health Science Center, School of Dentistry at Houston, Houston, TX, USA
| | - Veronique Delattre
- University of Texas Health Science Center, School of Dentistry at Houston, Houston, TX, USA
| | - Maria Kahn
- Harvard School of Dental Medicine, Boston, MA, USA
| | | | - Rachel B. Ramoni
- Center for Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Muhammad F. Walji
- University of Texas Health Science Center, School of Dentistry at Houston, Houston, TX, USA
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Olujide S, Ilyas N, Guni A. Common Difficult Scenarios for The Newly Qualified Dental Professional. Prim Dent J 2021; 10:63-68. [PMID: 34353155 DOI: 10.1177/20501684211012582] [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: 11/16/2022]
Abstract
Dental complaints are at the forefront of many dental practitioners' thoughts, with most dentists likely to have a complaint against them during their practicing lifetime. Difficult clinical scenarios can be particularly challenging for the newly qualified dental professional to manage, with a lack of experience potentially leading to an increased likelihood of a complaint. This article highlights several common clinical scenarios which dental practitioners are likely to face, providing a framework for their management and assessing the impact that the coronavirus pandemic may have on patients presenting for routine dental care.
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Affiliation(s)
- Segun Olujide
- Oral and Maxillofacial Surgery SHO, University Hospital of Wales, Cardiff, UK
| | - Nabeel Ilyas
- Specialist Registrar in Paediatric Dentistry, King's College Hospital, Denmark Hill, London, UK
| | - Alaa Guni
- Specialty Trainee in Periodontology, King's College London, UK
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Ensaldo-Carrasco E, Suarez-Ortegon MF, Carson-Stevens A, Cresswell K, Bedi R, Sheikh A. Patient Safety Incidents and Adverse Events in Ambulatory Dental Care: A Systematic Scoping Review. J Patient Saf 2021; 17:381-391. [PMID: 27611771 DOI: 10.1097/pts.0000000000000316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND There have been efforts to understand the epidemiology of iatrogenic harm in hospitals and primary care and to improve the safety of care provision. There has in contrast been very limited progress in relation to the safety of ambulatory dental care. OBJECTIVES To provide a comprehensive overview of the range and frequencies of existing evidence on patient safety incidents and adverse events in ambulatory dentistry. METHODS We searched MEDLINE and EMBASE for articles reporting events that could have or did result in unnecessary harm in ambulatory dental care. We extracted and synthesized data on the types and frequencies of patient safety incidents and adverse events. RESULTS Forty articles were included. We found that the frequencies varied very widely between studies; this reflected differences in definitions, populations studied, and sampling strategies. The main 5 PSIs we identified were errors in diagnosis and examination, treatment planning, communication, procedural errors, and the accidental ingestion or inhalation of foreign objects. However, little attention was paid to wider organizational issues. CONCLUSIONS Patient safety research in dentistry is immature because current evidence cannot provide reliable estimates on the frequency of patient safety incidents in ambulatory dental care or the associated disease burden. Well-designed epidemiological investigations are needed that also investigate contributory factors.
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Affiliation(s)
| | - Milton Fabian Suarez-Ortegon
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK
| | - Andrew Carson-Stevens
- Patient Safety Research Lead, Primary and Emergency Care Research (PRIME) Centre, Cardiff University, Wales; and Visiting Professor of Healthcare Improvement, Department of Family Practice, University of British Columbia
| | | | - Raman Bedi
- Professor and Head Centre for International Child Oral Health. King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, Division of Population and Patient Health, King's College London, UK
| | - Aziz Sheikh
- Professor of Primary Care Research & Development and Co-Director, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland
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24
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Bailey E. Wrong-sided? Br Dent J 2021; 230:387. [PMID: 33837315 DOI: 10.1038/s41415-021-2907-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
Patient safety should be at the heart of any healthcare service. Systems, teams, individuals and environments must work in tandem to strive for safety and quality. Research into patient safety in dentistry is still in the early stages. The vast majority of the research in this area has originated from the secondary care and academic fields. Approximately 95% of dental care is provided in the primary care sector. In this paper, we provide an overview of the evidence base for patient safety in dentistry and discuss the following aspects of patient safety: human factors; best practice; the second victim concept; potential for over-regulation and creating a patient safety culture. Through discussion of these concepts, we hope to provide the reader with the necessary tools to develop a patient safety culture in their practice.
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Affiliation(s)
- Edmund Bailey
- Senior Clinical Lecturer/Honorary Consultant in Oral Surgery, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London
| | - Mohammed Dungarwalla
- Academic Clinical Fellow and Specialist Registrar in Oral Surgery, Institute of Dentistry, Queen Mary University of London & The Royal London Dental Hospital, Barts Health NHS Trust, London
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Corrêa CDTSDO, Sousa P, Reis CT. Patient safety in dental care: an integrative review. CAD SAUDE PUBLICA 2020; 36:e00197819. [PMID: 33084835 DOI: 10.1590/0102-311x00197819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 06/29/2020] [Indexed: 11/22/2022] Open
Abstract
Adverse events pose a serious problem for quality of healthcare. Dental practice is eminently invasive and involves close and routine contact with secretions; as such, it is potentially prone to the occurrence of adverse events. Various patient safety studies have been developed in the last two decades, but mostly in the hospital setting due to the organizational complexity, severity of the cases, and diversity and specificity of the procedures. The objective was to identify and explore studies on patient safety in Dentistry. An integrative literature review was performed in MEDLINE via PubMed, Scopus via Portal Capes, and the Regional Portal of the Virtual Health Library, using the terms patient safety and dentistry in English, Spanish, and Portuguese, starting in 2000. The research cycle in patient safety was used, as proposed by the World Health Organization to classify studies. We analyzed 91 articles. The most common adverse events were allergies, infections, diagnostic delay or failure, and technical error. Measures to mitigate the problem highlight the need to improve communications, encourage reporting, and search for tools to assist the management of care. The authors found a lack of studies on implementation and assessment of the impact of proposals for improvement. Dentistry has made progress in patient safety but still needs to transpose the results into practice, where efforts are crucial to prevent adverse events.
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Affiliation(s)
| | - Paulo Sousa
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal.,Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal
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Al-Mahalawy H, El-Mahallawy Y, El Tantawi M. Dentists' practices and patient safety: A cross-sectional study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:381-389. [PMID: 32053278 DOI: 10.1111/eje.12513] [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: 07/30/2019] [Revised: 01/28/2020] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
PURPOSE To assess the frequency of dentist-reported practices to ensure patient safety in the dental office and the impact of training and work environment on this frequency using the framework of the International Patient Safety Goals (IPSGs). METHODS Dentists attending major conferences in Egypt and Saudi Arabia were recruited in a cross-sectional study in 2018. They completed a questionnaire assessing professional background and the frequency of practices for the IPSGs. The relationship between explanatory variables: training (postgraduate degrees and continuing education) and work environment (years in profession, working in public sector and performing surgical procedures) and the outcome variable: frequency of practices for 4 IPSGs was assessed using multivariate general linear model, and univariate general linear model was used to assess their relationship to the overall score of safety practices calculated for all goals. RESULTS The response rate was 81.1%. Practices related to reducing harm in the office environment were significantly less frequent than practices ensuring medication safety, ensuring safe surgery and controlling infection. The overall frequency of safety practices was significantly higher amongst senior than junior dentists. There were significant differences in safety practices frequency based on postgraduate degrees and receiving safety training. Dentists performing surgical procedures reported less frequent safety practices. CONCLUSION Practices to reduce harm because of the dental office environment were less frequent than other safety practices. Senior dentists, dentists who had postgraduate degrees and who received safety training reported more safety practices whilst those performing surgical procedures reported fewer safety practices.
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Affiliation(s)
- Haytham Al-Mahalawy
- Biomedical Dental Sciences Department, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Yehia El-Mahallawy
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Liew J, Beech A. Implementation of “local safety standards for invasive procedures (LocSSIPs)” policy: not merely a tick-box exercise in patient safety. Br J Oral Maxillofac Surg 2020; 58:421-426. [DOI: 10.1016/j.bjoms.2020.01.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 01/23/2020] [Indexed: 10/24/2022]
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29
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Almufleh B, Ducret M, Malixi J, Myers J, Nader SA, Franco Echevarria M, Adamczyk J, Chisholm A, Pollock N, Emami E, Tamimi F. Development of a Checklist to Prevent Reconstructive Errors Made By Undergraduate Dental Students. J Prosthodont 2020; 29:573-578. [PMID: 32282105 DOI: 10.1111/jopr.13177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/22/2020] [Accepted: 04/04/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To design a checklist in order to reduce the frequency of reconstructive preventable errors (PE) performed by undergraduate dental students at McGill University. MATERIALS AND METHODS The most common PE occurring at a university dental clinic were identified by three reviewers analyzing the refunded cases, and used to create a preliminary checklist. This checklist was then validated by a panel of dental educators to produce a finalized 20-item checklist. The 20-question checklist was then submitted to students in a cross-sectional survey-based study to evaluate its relevance to undergraduate clinical education needs. RESULTS As many as 81% of students reported to have forgotten at least one item of the checklist during care of their last patient, and the most forgotten checklist items corresponded to the pretreatment stage. The students also reported that 17 of the 20 items in the checklist were relevant to a considerable extent or highly relevant. CONCLUSION Common PE identified in the undergraduate clinic could be used to create a checklist of relevant items designed to reduce errors made by students and practitioners performing prosthodontic and reconstructive treatments. However, further studies are required to evaluate the implementation and efficiency of the checklist.
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Affiliation(s)
- Balqees Almufleh
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,King Saud University, Riyadh, Saudi Arabia
| | - Maxime Ducret
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Faculty of Dentistry, Lyon 1 University, Lyon, France.,Odontology Center, Lyon Civils Hospices, Lyon, France
| | - Jodeci Malixi
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Jeffrey Myers
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Samer Abi Nader
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | | | - Jessica Adamczyk
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Alicia Chisholm
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Natalie Pollock
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,College of Dental Medicine, Qatar University, Doha, Qatar
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Wali R, Halai T, Koshal S. WHO surgical safety checklist training: An alternative approach to training in local safety standards for invasive procedures. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:71-78. [PMID: 31518469 DOI: 10.1111/eje.12469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 08/07/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Despite efforts to promote the effective use of the WHO surgical safety checklist, wrong tooth extractions have continued to occur within dentistry. METHOD A training initiative combined methods of teaching comprising of a presentation, video and simulation to deliver LocSSIP training at an Oral Surgery Department of a UK dental hospital. Participant feedback was analysed to determine their perception of using combined methods to deliver the training. RESULT Overall feedback was very positive with regard to relevance of the training, and its ability to meet the learning needs of all participants. Participants advocated that there should be regular re-training and incorporation of this training into the local induction programme. Almost About 94% of staff members Strongly Agreed or Agreed that they would recommend this format of training to other departments. CONCLUSION Effective training is essential to maintain safe clinical practice within health care, and training methods that are inclusive of various learning styles are well received.
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The evolution of patient safety procedures in an oral surgery department. Br Dent J 2019; 226:32-38. [PMID: 30631172 DOI: 10.1038/sj.bdj.2019.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2018] [Indexed: 11/09/2022]
Abstract
NHS Improvement highlights the importance of providing consistently safe care within the NHS. For dental professionals, this particularly concerns the reporting and avoidance of never events such as wrong tooth extraction and other serious incidents. Within the authors' unit, a number of infrequent never events and the national drive to introduce safety frameworks (NatSSIPs) has led to a reassessment of our safety procedures. In this paper, as part of our safety improvements, we discuss the chronological changes made in safety procedures following untoward events. Subsequently, we introduced a surgical safety briefing (the 'huddle') within the outpatient setting where we undertake invasive oral surgery procedures under local anaesthetic including intravenous sedation. By supplementing the 'huddle' with human factors training for all clinical staff there have been no further never events or serious incidents in the last two and a half years.
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Remiszewski DP, Bidra AS. Implementation of a surgical safety checklist for dental implant surgeries in a prosthodontics residency program. J Prosthet Dent 2019; 122:371-375. [DOI: 10.1016/j.prosdent.2019.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 03/06/2019] [Accepted: 03/06/2019] [Indexed: 11/17/2022]
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Choi EM, Mun SJ, Chung WG, Noh HJ. Relationships between dental hygienists' work environment and patient safety culture. BMC Health Serv Res 2019; 19:299. [PMID: 31077202 PMCID: PMC6509757 DOI: 10.1186/s12913-019-4136-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 04/30/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Patient safety culture is a core factor in increasing patient safety, is related to the quality of medical service, and can lower the risk of patient safety accidents. However, in dentistry, research has previously focused mostly on reporting of patient safety accidents. Dental professionals' patient safety culture must therefore first be assessed, and related factors analyzed to improve patient safety. METHODS This cross-sectional study completed a survey on 377 dental hygienists working in dental settings. To assess patient safety culture, we used a survey with proven validity and reliability by translating the Hospital Survey on Patient Safety Culture (HSOPS) developed by Agency for Healthcare Research and Quality (AHRQ) into Korean. Response options on all of the items were on 5-point Likert-type scales. SPSS v21 was used for statistical analysis. The relationships between workplace factors and patient safety culture were examined using t-tests and one-way analysis of variance (ANOVA) tests(p < 0.05). RESULTS The work environment of dental hygienists has a close relationship with patient safety. Dental hygienists working ≥40 h/week in Korea had a significantly lower for patient safety grade than those working < 40 h/week. When the number of patients per day was less than 8, the safety level of patients was significantly higher. And significant differences were found depending on institution type, institution size. CONCLUSIONS In order to establish high-quality care and patient safety system practical policies must be enacted. In particular, assurance in the quality of work environment such as sufficient staffing, appropriate work hours, and enough rest must first be realized before patient safety culture can easily be formed.
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Affiliation(s)
- Eun-Mi Choi
- Department of Dental Hygiene, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - So-Jung Mun
- Department of Dental Hygiene, Yonsei University Wonju College of Medicine, 20 Ilsanro, Wonju, Kangwondo, 26426, Republic of Korea
| | - Won-Gyun Chung
- Department of Dental Hygiene, Yonsei University Wonju College of Medicine, 20 Ilsanro, Wonju, Kangwondo, 26426, Republic of Korea
| | - Hie-Jin Noh
- Department of Dental Hygiene, Yonsei University Wonju College of Medicine, 20 Ilsanro, Wonju, Kangwondo, 26426, Republic of Korea.
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Never events: Patient safety definitions. Br Dent J 2018; 225:795-796. [DOI: 10.1038/sj.bdj.2018.986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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35
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Wright S, Ucer TC, Crofts G. The adaption and implementation of the WHO Surgical Safety Checklist for dental procedures. Br Dent J 2018; 225:sj.bdj.2018.861. [PMID: 30337725 DOI: 10.1038/sj.bdj.2018.861] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2018] [Indexed: 11/08/2022]
Affiliation(s)
- S Wright
- School of Health Sciences, University of Salford
| | - T C Ucer
- School of Health Sciences, University of Salford
| | - G Crofts
- School of Health Sciences, University of Salford
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The development and implementation of a biopsy safety strategy for oral medicine. Br Dent J 2018; 223:667-673. [PMID: 29123305 DOI: 10.1038/sj.bdj.2017.885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2017] [Indexed: 11/08/2022]
Abstract
The development and implementation of a biopsy safety strategy is described in this article. Analysis of previous adverse incidents relating to biopsies acted as a catalyst to review our biopsy pathway at Liverpool University Dental Hospital. Input from all staff involved enabled us to develop a biopsy safety strategy which was divided into five stages: preoperative assessment of patient and procedure, team briefings, biopsy surgical safety checklist, surgical removal and handling of biopsy specimens, and post-biopsy follow-up. It is hoped that other clinical teams will take the opportunity to review their own biopsy processes, in the light of our experience.
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Developing agreement on never events in primary care dentistry: an international eDelphi study. Br Dent J 2018; 224:733-740. [DOI: 10.1038/sj.bdj.2018.351] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 11/08/2022]
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Corrêa CDTSDO, Mendes W. Proposal of a trigger tool to assess adverse events in dental care. CAD SAUDE PUBLICA 2017; 33:e00053217. [PMID: 29166475 DOI: 10.1590/0102-311x00053217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 08/07/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to propose a trigger tool for research of adverse events in outpatient dentistry in Brazil. The tool was elaborated in two stages: (i) to build a preliminary set of triggers, a literature review was conducted to identify the composition of trigger tools used in other areas of health and the principal adverse events found in dentistry; (ii) to validate the preliminarily constructed triggers a panel of experts was organized using the modified Delphi method. Fourteen triggers were elaborated in a tool with explicit criteria to identify potential adverse events in dental care, essential for retrospective patient chart reviews. Studies on patient safety in dental care are still incipient when compared to other areas of health care. This study intended to contribute to the research in this field. The contribution by the literature and guidance from the expert panel allowed elaborating a set of triggers to detect adverse events in dental care, but additional studies are needed to test the instrument's validity.
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Affiliation(s)
| | - Walter Mendes
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Patient safety: reducing the risk of wrong tooth extraction. Br Dent J 2017; 222:759-763. [DOI: 10.1038/sj.bdj.2017.448] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 11/09/2022]
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40
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Black I, Bowie P. Patient safety in dentistry: development of a candidate 'never event' list for primary care. Br Dent J 2017; 222:782-788. [DOI: 10.1038/sj.bdj.2017.456] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 11/09/2022]
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Vehkalahti MM, Swanljung O. Operator-related aspects in endodontic malpractice claims in Finland. Acta Odontol Scand 2017; 75:155-160. [PMID: 28049372 DOI: 10.1080/00016357.2016.1272000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We analyzed operator-related differences in endodontic malpractice claims in Finland. MATERIALS AND METHODS Data comprised the endodontic malpractice claims handled at the Patient Insurance Centre (PIC) in 2002-2006 and 2011-2013. Two dental advisors at the PIC scrutinized the original documents of the cases (n = 1271). The case-related information included patient's age and gender, type of tooth, presence of radiographs, and methods of instrumentation and apex location. As injuries, we recorded broken instrument, perforation, injuries due to root canal irrigants/medicaments, and miscellaneous injuries. We categorized the injuries according to the PIC decisions as avoidable, unavoidable, or no injury. Operator-related information included dentist's age, gender, specialization, and service sector. We assessed level of patient documentation as adequate, moderate, or poor. Chi-squared tests, t-tests, and logistic regression modelling served in statistical analyses. RESULTS Patients' mean age was 44.7 (range 8-85) years, and 71% were women. The private sector constituted 54% of claim cases. Younger patients, female dentists, and general practitioners predominated in the public sector. We found no sector differences in patients' gender, dentists' age, or type of injured tooth. PIC advisors confirmed no injury in 24% of claim cases; the advisors considered 65% of injury cases (n = 970) as avoidable and 35% as unavoidable. We found no operator-related differences in these figures. Working methods differed by operator's age and gender. Adequate patient documentation predominated in the public sector and among female, younger, or specialized dentists. CONCLUSIONS Operator-related factors had no impact on endodontic malpractice claims.
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Affiliation(s)
- Miira M. Vehkalahti
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Outi Swanljung
- Department of Oral Health Care, The Patient Insurance Centre, Helsinki, Finland
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42
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The complexity of patient safety reporting systems in UK dentistry. Br Dent J 2016; 221:517-524. [DOI: 10.1038/sj.bdj.2016.782] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2016] [Indexed: 11/08/2022]
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Renton T, Sabbah W. Review of never and serious events related to dentistry 2005–2014. Br Dent J 2016; 221:71-9. [DOI: 10.1038/sj.bdj.2016.526] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 11/09/2022]
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44
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Yeung CA. Patient safety: Scottish Patient Safety Programme. Br Dent J 2016; 220:155. [DOI: 10.1038/sj.bdj.2016.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Tickle M, O' Malley L, Brocklehurst P, Glenny AM, Walsh T, Campbell S. A national survey of the public's views on quality in dental care. Br Dent J 2015; 219:E1. [PMID: 26271885 DOI: 10.1038/sj.bdj.2015.595] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is a lack of evidence and poor understanding of quality measurement and improvement in dentistry. The aim of this study was to undertake a nationally representative survey of the public in England to explore their views on the meaning of quality in dentistry. METHODS A cross sectional survey of the adult population (18 years and over) of England was undertaken. A sample size of 500 was set to provide a precision to plus or minus 5% after allowing for item non-response. A quota sampling approach was used, with predetermined quotas set for sex, age, working status and tenure to ensure the sample was nationally representative. Question selection and design were informed by the literature and a series of interviews with the public. Simple content analysis was used to identify themes in the responses to open questions. Dental service use, gender, age, ethnicity and social class were recorded. Frequency distributions were computed and outputs were cross-tabulated with various population sub-group categories. RESULTS Five hundred and thirteen people were interviewed. Approximately 20% of patients reported that their care was suboptimal; a third thought it was poor value for money and 20% did not trust their dentist. Good interpersonal communication, politeness and being put at ease were the most important factors that elicited positive responses. Negative factors were cost of care and waiting times. In making an assessment of quality, access (40% of all responses), technical quality of care (35%), professionalism (30%), hygiene/cleanliness (30%), staff attitude (27%), pain-free treatment (23%), value for money (22%), and staff putting patients at ease (21%) all emerged as important factors. CONCLUSIONS Quality in dentistry is multi-dimensional in nature, and includes different elements and emphases to other areas of healthcare. The results will inform the development of a measure of quality in dentistry.
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Affiliation(s)
- M Tickle
- Institute of Population Health, University of Manchester
| | - L O' Malley
- School of Dentistry, University of Manchester
| | - P Brocklehurst
- 1] School of Dentistry, University of Manchester [2] NWORTH Trials Unit, Bangor University, Holyhead Road, Gwynedd, LL57 2PZ
| | - A-M Glenny
- School of Dentistry, University of Manchester
| | - T Walsh
- School of Dentistry, University of Manchester
| | - S Campbell
- Institute of Population Health, University of Manchester, Oxford Road, Manchester, M13 9PL
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