1
|
Boyer L, Wu AW, Fernandes S, Tran B, Brousse Y, Nguyen TT, Yon DK, Auquier P, Lucas G, Boussat B, Fond G. Exploring the fear of clinical errors: associations with socio-demographic, professional, burnout, and mental health factors in healthcare workers - A nationwide cross-sectional study. Front Public Health 2024; 12:1423905. [PMID: 38989124 PMCID: PMC11233687 DOI: 10.3389/fpubh.2024.1423905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/11/2024] [Indexed: 07/12/2024] Open
Abstract
Background The fear of clinical errors among healthcare workers (HCW) is an understudied aspect of patient safety. This study aims to describe this phenomenon among HCW and identify associated socio-demographic, professional, burnout and mental health factors. Methods We conducted a nationwide, online, cross-sectional study targeting HCW in France from May to June 2021. Recruitment was through social networks, professional networks, and email invitations. To assess the fear of making clinical errors, HCW were asked: "During your daily activities, how often are you afraid of making a professional error that could jeopardize patient safety?" Responses were collected on a 7-point Likert-type scale. HCW were categorized into "High Fear" for those who reported experiencing fear frequently ("once a week," "a few times a week," or "every day"), vs. "Low Fear" for less often. We used multivariate logistic regression to analyze associations between fear of clinical errors and various factors, including sociodemographic, professional, burnout, and mental health. Structural equation modeling was used to explore how this fear fits into a comprehensive theoretical framework. Results We recruited a total of 10,325 HCW, of whom 25.9% reported "High Fear" (95% CI: 25.0-26.7%). Multivariate analysis revealed higher odds of "High Fear" among males, younger individuals, and those with less professional experience. High fear was more notable among physicians and nurses, and those working in critical care and surgery, on night shifts or with irregular schedules. Significant associations were found between "High Fear" and burnout, low professional support, major depressive disorder, and sleep disorders. Conclusions Fear of clinical errors is associated with factors that also influence patient safety, highlighting the importance of this experience. Incorporating this dimension into patient safety culture assessment could provide valuable insights and could inform ways to proactively enhance patient safety.
Collapse
Affiliation(s)
- Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France
- Department of Public Health, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Albert W Wu
- Johns Hopkins University Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Sara Fernandes
- CEReSS-Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France
- Department of Public Health, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Bach Tran
- CEReSS-Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Yann Brousse
- CEReSS-Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France
| | - Tham Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Pascal Auquier
- CEReSS-Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France
- Department of Public Health, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Guillaume Lucas
- CEReSS-Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France
| | - Bastien Boussat
- TIMC-IMAG, UMR 5525 Joint Research Unit, Centre National de Recherche Scientifique, National Center for Scientific Research, Université Grenoble-Alpes, Grenoble, France
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France
- Department of Public Health, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| |
Collapse
|
2
|
Ngaledzani RI, Ndou-Mammbona AA, Mavhandu-Mudzusi AH. The Effect on Theatre Nurses for Rendering Perioperative Care to Patients Living with HIV in a South African Tertiary Hospital. AIDS Res Treat 2023; 2023:1889208. [PMID: 37750059 PMCID: PMC10518239 DOI: 10.1155/2023/1889208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 09/27/2023] Open
Abstract
Purpose The study aimed to gain an in-depth understanding of how theatre nurses are being affected when they render perioperative care to patients living with HIV in a South African tertiary hospital. Background There is a scarcity of studies that focus solely on the wellbeing of theatre nurses who render perioperative care to HIV patient due to the ramifications of the nurses' fear of contracting HIV. Patients living with HIV often receive substandard care. Objectives To establish how theatre nurses are being impacted when rendering perioperative care to patient living with HIV, the study followed a qualitative approach using an interpretative phenomenological analysis design. Data were collected through in-depth individual interviews from ten theatre nurses who were purposively selected according to specific criteria. They voluntarily agreed to participate. An interpretive phenomenological analysis framework was used to analyse the data. Two main themes emerged from the data analysis, namely, the negative effect on nurses' wellbeing and the impact that it had on them professionally. Results The study revealed that the perioperative care of patients living with HIV had a negative impact on physical, mental, and social wellbeing of theatre nurses. Their compromised wellbeing in turn led to poor patient care, which put nurses at risk of losing their jobs and even potentially having to face litigation. The study further indicated that nurses did not receive psychological support from the management which further affected their health and professional performance. Conclusion The study proposes that theatre nurses rendering perioperative care to people living with HIV should receive proper training and support; staff shortages should also be addressed. There is also an urgent need for appropriate and sufficient protective equipment. Such changes will be essential in order to mitigate the negative impact that their jobs have on their wellbeing and on them in their professional capacity.
Collapse
|
3
|
Kerray FM, Yule SJ, Tambyraja AL. Formalizing the Hidden Curriculum of Performance Enhancing Errors. JOURNAL OF SURGICAL EDUCATION 2023; 80:619-623. [PMID: 36863898 DOI: 10.1016/j.jsurg.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/23/2022] [Accepted: 01/22/2023] [Indexed: 06/19/2023]
Abstract
Despite its inevitability, error remains an uncomfortable topic for discussion amongst surgeons. There are a range of reasons cited for this; significantly, there is an inextricable link between a surgeon's actions and their patient's outcomes. Attempts to reflect on error are often unstructured and without a defined end point, and modern surgical curricula lack content to guide residents' learning on recognizing and reflecting on sentinel events. There is a need to develop a tool to guide a standardized, safe, and constructive response to error. The current educational paradigm revolves around error avoidance. However, there is an evolving evidence base surrounding the inclusion of error management theory (EMT) into surgical training. This method explores and incorporates positive discussions surrounding errors, and has been demonstrated to improve long-term skill acquisition and training outcomes. We must harness the performance enhancing effects of our errors in the same way we do our successes. Implicated in all surgical performance is human factors science/ergonomics (HFE) - the interface between psychology, engineering, and performance. Developing a national HFE curriculum in the context of EMT would provide a common language to facilitate objective reflections regarding surgeons' operative performance and manage the stigma associated with fallibility.
Collapse
Affiliation(s)
- Fiona M Kerray
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, Scotland; Edinburgh Vascular Service, Royal Infirmary of Edinburgh, Edinburgh, Scotland.
| | - Steven J Yule
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, Scotland
| | - Andrew L Tambyraja
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, Scotland; Edinburgh Vascular Service, Royal Infirmary of Edinburgh, Edinburgh, Scotland
| |
Collapse
|
4
|
Reminding staff of diligence during the medication process is not enough to ensure safety: Learning from wrong fluid product selection incidents in the care of critically ill patients. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 8:100181. [PMID: 36204010 PMCID: PMC9529580 DOI: 10.1016/j.rcsop.2022.100181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 07/27/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022] Open
Abstract
Background and objectives Wrong fluid product selection may cause harm to patients. This study aimed to describe voluntarily reported wrong fluid product selection incidents, including their consequences, the reported latent conditions and active failures leading to these and the suggested safeguards to prevent their occurrence, and to compare the suggested and literature-based safeguards to improve the fluid therapy safety within the intensive care (ICU) environment. Methods All voluntarily and anonymously reported wrong fluid product selection incidents in all Finnish ICUs during 2007–2017 were reviewed. The incident reports included categorized data that were analyzed quantitatively, and narratives that were analyzed qualitatively, using content analysis. The results were reported as frequencies and percentages and described by using Reason's model of human error. Results Over the eleven years, one wrong fluid product selection incident was reported every six days (n = 663; 584 errors, 79 near misses); most were reported to have occurred during the dispensing/preparing phase (92%). Of the 584 reported selection errors, a quarter (26%) was reported to have caused consequences to patients, and one third (35%) to have required corrective or monitoring actions. The main reported latent conditions to the incidents were Working environment and resources (e.g. workload and time pressure) (29%), Similar-looking and -sounding names or shared features of the product containers (i.e. the LASA phenomenon) (28%) and Working methods (22%); and the main reported active failures were a lack of concentration, or forgetfulness (26%). Some usable suggestions of safeguards were made, e.g. optimizing fluid storage (15%) or utilizing checking practices (21%). While requiring accuracy, i.e. reminding staff of diligence and to be more attentive to detail during the whole medication process, was emphasized in most reports (71%), involving manufacturers in redesigning labels of fluid products, utilizing technology and strengthening pharmacy services are advocated existing literature. Conclusions Wrong fluid product selection incidents with various latent conditions and active failures were reported more than once a week. To minimize the serious LASA phenomenon, multi-professional collaboration, coordinated international discussion and agreements of solutions with manufacturers, regulators and end-users, are needed. However, work is also needed to reduce the other latent factors, such as Working environment and resources as well as cognitive biases in daily work that may contribute to the occurrence of LASA related errors.
Collapse
|
5
|
Factors influencing patient safety culture in operating room in a teaching hospital in Jordan: a qualitative descriptive study. TQM JOURNAL 2022. [DOI: 10.1108/tqm-04-2022-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeTo explore the perceptions of surgical team members in a tertiary hospital in Jordan toward the factors influencing patient safety culture (PSC).Design/methodology/approachThis was a qualitative descriptive study intended to characterize the factors that influence PSC. Interviews were conducted with health-care providers in the operation room (OR) in a tertiary Jordanian hospital. Participants included surgeons, anesthetists, nurses and senior surgical residents who had worked for three years minimum in the OR. Thematic analysis was used to analyze the data.FindingsA total of 33 interviews were conducted. Thematic analysis of the content yielded four major themes: (1) operational factors, (2) organizational factors, (3) health-care professionals factors and (4) patient factors. The respondents emphasized the role of the physical layout of the OR, implementing new techniques and new equipment, and management support to establish a safety culture in the operating room setting.Originality/valueThe present research study will have implications for hospitals and health-care providers in Jordan for developing organizational strategies to eliminate or decrease the occurrence of adverse events and improve patient safety in the OR.
Collapse
|