The patient safety culture perception of Turkish nurses who work in operating room and intensive care unit

The association of teamwork and missed nursing care in acute care setting: A mixed-methods systematic review

AIM(S)

Teamwork among healthcare professionals is a key aspect of patient safety that influences the prevalence of missed nursing care. The association between teamwork and missed care in acute care hospitals is now well established in the literature. Therefore, this review aimed to synthesise the existing empirical evidence on the association between teamwork and missed care in the acute care setting.

DESIGN

A mixed-method systematic review study.

METHODS

The search was carried out in February 2023 in four scientific databases, PubMed, ProQuest, Web of Science and Scopus based on their institutional availability. The search produced 1542 studies. The method of thematic analysis was used in data synthesis.

RESULTS

A total of 18 studies were selected that revealed the relationship between teamwork and missed care. The teamwork score was weak to moderate but significantly associated with the overall score of missed care and was found to be a statistically significant predictor of missed care in an acute care setting. Additionally, teamwork represented an important reason for missed care, primarily in the context of poor communication, lack of trust and cooperation in the nursing team and lack of leadership.

CONCLUSION

The review findings contribute to a deeper understanding of the intricate dynamics between teamwork and missed care and provide valuable information to healthcare professionals and institutions looking to optimise teamwork and mitigate instances of missed care in the acute care setting.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Recognising how teamwork influences the occurrence of missed care, healthcare organisations can strategically implement targeted interventions to enhance collaboration, address communication gaps, foster trust, and provide effective leadership.

IMPACT

This review suggests that improving teamwork seems to be one of the most important strategies focused on mitigating missed care in acute care settings.

REPORTING METHOD

The reporting of this review followed the PRISMA 2020 checklist.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Evaluating patient safety research performance in Arab world countries: Changing trends and reflections

Background and Objective

Patient safety is a major concern in health care. Research is an important tool to minimize preventable errors. Research performance and trends evaluation need to be identified for future guidance. Our objective was to evaluate the research performance in Arab World countries related to patient safety so that real picture is available to all stake holders for future application.

Methods

This was a descriptive exploratory study carried at King Abdulaziz University Jeddah, using Bibliometric analyses on Web of Science extracted data, exploring the research publications related to Patient Safety from the Arab World in last two decades (2001-2020). Digital resources were used. Data collected was further explored to see the trends.

Results

Only 2% of total worldwide publications on Patient Safety were from Arab World. A positive trend, however, has emerged since 2015. Out of 5940 documents identified, only 383 had single authorship. Egypt and Saudi Arab were the major contributors. Other countries had less or even zero publications. Researchers are coordinating with others in Western countries to enhance the research productivity. Cairo University with 734 publications had most affiliations. Publications on safety culture and medication safety were frequent. Hospital Acquired Infections and error reporting had limited research.

Conclusion

Researches on patient safety in the Arab World are not sufficient. Countries other than Egypt and Saudi Arabia also need to contribute more frequently. Critical problems, like Hospital Acquired Infections, should have regular research from all countries to assist those treating patients and those making health related policies.

Status and Factors Affecting Patient Safety Culture at Dilla University Teaching Hospital: A Mixed-Method Cross-Sectional Study

Background

Patient safety culture is now at the forefront of the global health agenda and has been designated as a human right. Assessing safety culture is seen to be a prerequisite for improving safety culture in health-care organizations. However, no research has been conducted to examine the current study setup. Therefore, this study aims at assessing the status and factors influencing patient safety culture at Dilla University Teaching Hospital.

Methods

This cross-sectional institutional-based study was conducted from February to March 2022 at Dilla University Hospital. The study used both qualitative and quantitative methods. A total of 272 health professionals were included in the survey. The qualitative data was collected using Key Informant Interviews and In-depth Interviews and 10 health professionals were selected purposively to meet the study objective.

Results

The overall composite positive patient safety culture response rate in the current study hospital was 37% (95% CI: 35.3, 38.8). Out of the 12 dimensions, teamwork within hospital units was the highest (75.3%), while frequency of event reporting was the lowest (20.7%) positive percentage response. Only two of the 12 dimensions scored above 50%. Factors affecting patient safety culture majorly at organizational and individual level were poor/low attitude of health professionals, poor documentation practice, and poor cooperation by clients, lack of training and continuous education, lack of standard operating procedure, Staff shortage and high work load.

Conclusion

This study revealed that the overall composite positive patient safety culture response rate within the surveyed facility was alarmingly low compared to other hospitals in various countries. The results indicate that there is a need for improvement in areas such as event reporting, documentation, health-care workers' attitude, and staff training. Hospitals must prioritize patient safety by cultivating a strong safety culture through effective leadership, adequate staffing, and education to enhance overall patient care.

Analysis of Factors Influencing Safety Attitudes of Operating Room Nurses and Their Cognition and Attitudes toward Adverse Event Reporting

Operating room nurses play a critical role in patient safety. The evaluation of safety attitudes of operating room nurses reflects their awareness and belief of patient safety. Currently, however, the research on the safety attitudes of operating room nurses is hard to track in the existing literature in China. Therefore, this paper was conducted to explore the factors influencing the safety attitudes of operating room nurses and their cognition and attitudes toward adverse event reporting. A total of 711 operating room nurses from 16 tertiary hospitals in Sichuan Province from March 1, 2018, to 2019 were selected. The general information of operating room nurses, such as age, gender, and years of service in the operating room, was obtained through the basic information questionnaire. The Chinese version of the Safety Attitudes Questionnaire (C-SAQ) was used to evaluate the safety attitude of operating room nurses, and the cognition and attitude of the subjects to adverse event reports were assessed through the questionnaire of cognition and attitude toward adverse event reporting. The average score of safety attitudes of operating room nurses was 4.20 ± 0.49. The two dimensions with a lower positive reaction rate of the safety attitudes of operating room nurses were stress recognition and working conditions. The main factors affecting the safety attitude of operating room nurses were night shifts, as well as cognition and attitudes toward adverse event reporting. There was a positive correlation between the total score of C-SAQ and the total score of cognition and attitudes toward adverse event reporting (P < 0.01, r = 0.445). The safety attitude of operating room nurses is at the upper-middle level, but the stress recognition and working conditions need to be improved. Through the allocation of nursing human resources, the strengthening of hospital logistics support, and the establishment of nonpunitive nursing adverse event reporting system, the operating room safety can be significantly enhanced.

The association between self-reported workload and perceptions of patient safety culture: A study of intensive care unit nurses

AIM AND OBJECTIVE

This study aimed to examine the association between workload and patient safety culture (PSC) among intensive care unit (ICU) nurses.

BACKGROUND

ICU nurses play a vital role in promoting patient safety and are essential indicators in any healthcare system including ICUs. Research studies focusing on the relationship between nursing workload and PSC among ICU nurses are limited.

DESIGN

Descriptive correlational design.

METHODS

The study participants involved 380 ICU nurses at two hospitals in Riyadh, Saudi Arabia. Data were collected between February 2019-April 2019 and were analysed using SPSS v.22 statistical software. This study was guided by the STROBE checklist.

RESULTS

The results showed that ICU nurses have high positive perceptions in the following PSC subscales: teamwork within units, organisational learning-continuous improvement, frequency of events reported, feedback and communication about error, management support for patient safety, teamwork across units, supervisor/manager expectations and actions promoting patient safety, handoffs and transitions, nonpunitive response to errors, staffing and overall perceptions of patient safety. However, the participants collectively considered the overall grade on patient safety as poor. The participants had high mean scores in physical demand, effort, mental demand and overall workload. A statistically significant variability existed in the mean scores of the PSC subscales and workload of ICU nurses. The overall workload was significantly and negatively associated with the PSC perceptions of ICU nurses.

CONCLUSION

The ICU nurses experienced high overall workload, physical demand, effort and mental demand which influenced the poor grade of their overall perceived PSC.

RELEVANCE TO CLINICAL PRACTICE

Identifying differences and associations with the perceptions of ICU nurses regarding workload and PSC is important because such perceptions may affect their delivery of nursing care. Hospital and nursing administrators must use the study results to find strategies that address workload issues and enhance patient safety.