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Gómez-Moreno C, Vélez-Vélez E, Garrigues Ramón M, Rojas Alfaro M, García-Carpintero Blas E. Patient safety in surgical settings: A study on the challenges and improvement strategies in adverse event reporting from a nursing perspective. J Clin Nurs 2024; 33:2324-2336. [PMID: 38308406 DOI: 10.1111/jocn.17047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/06/2023] [Accepted: 01/19/2024] [Indexed: 02/04/2024]
Abstract
AIMS To explore adverse event reporting in the surgical department through the nurses' experiences and perspectives. DESIGN An exploratory, descriptive qualitative study was conducted with a theoretical-methodological orientation of phenomenology. METHODS In-depth interviews were conducted with 15 nurses, followed by an inductive thematic analysis. RESULTS Themes include motives for reporting incidents, consequences, feelings and motivational factors. Key facilitators of adverse event reporting were effective communication, knowledge sharing, a non-punitive culture and superior feedback. CONCLUSION The study underscores the importance of supportive organisational culture for reporting, communication and feedback mechanisms, and highlights education and training in enhancing patient safety. IMPLICATIONS It suggests the need for strategies that foster incident reporting, enhance patient safety and cultivate a supportive organisational culture. IMPACT This study provides critical insights into adverse event reporting in surgical departments from nurses' lived experience, leading to two primary impacts: It offers specific solutions to improve adverse event reporting, which is crucial for surgical departments to develop more effective and tailored reporting strategies. The research underscores the importance of an open, supportive culture in healthcare, which is vital for transparent communication and effective reporting, ultimately advancing patient safety. REPORTING METHOD The study followed the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines. PATIENTS OR PUBLIC CONTRIBUTION No patients or public contribution.
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Affiliation(s)
- Cristina Gómez-Moreno
- Fundación Jiménez Díaz School of Nursing - Health Research Institute-Fundación, Jiménez Díaz University Hospital - UAM (IIS-FJD, UAM), Madrid, Spain
| | - Esperanza Vélez-Vélez
- Fundación Jiménez Díaz School of Nursing - Health Research Institute-Fundación, Jiménez Díaz University Hospital - UAM (IIS-FJD, UAM), Madrid, Spain
| | - Marta Garrigues Ramón
- Fundación Jiménez Díaz School of Nursing - Health Research Institute-Fundación, Jiménez Díaz University Hospital - UAM (IIS-FJD, UAM), Madrid, Spain
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Brás CPDC, Figueiredo MDCABD, Ferreira MMC. Safety culture in maternity hospital: Perception of nurse-midwives. J Adv Nurs 2024; 80:2091-2105. [PMID: 38012856 DOI: 10.1111/jan.15969] [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: 02/06/2023] [Revised: 10/26/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
AIM To explore nurse-midwives' perceptions of safety culture in maternity hospitals. DESIGN A descriptive phenomenological study was conducted using focus groups and reported following the Consolidated Criteria for Reporting Qualitative Research. METHODS Data were obtained through two online focus group sessions in June 2022 with 13 nurse-midwives from two maternity hospitals in the central region of Portugal. The first focus group comprised 6 nurse-midwives, and the second comprised 7 nurse-midwives. Qualitative data were analysed using content analysis. FINDINGS Two main themes emerged from the data: (i) barriers to promoting a safety culture; (ii) safety culture promotion strategies. The first theme is supported by four categories: ineffective communication, unproductive management, instability in teams and the problem of errors in care delivery. The second theme is supported by two categories: managers' commitment to safety and the promotion of effective communication. CONCLUSION The study results show that the safety culture in maternity hospitals is compromised by ineffective communication, team instability, insufficient allocation of nurse-midwives, a prevailing punitive culture and underreporting of adverse events. These highlight the need for managers to commit to providing better working conditions, encourage training with the development of a fairer safety culture and encourage reporting and learning from mistakes. There is also a need to invest in team leaders who allow better conflict management and optimization of communication skills is essential. IMPACT Disseminating these results will provide relevance to the safety culture problem, allowing greater awareness of nurse-midwives and managers about vulnerable areas, and lead to the implementation of effective changes for safe maternal and neonatal care. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution as the study only concerned service providers, that is, nurse-midwives themselves.
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Affiliation(s)
| | | | - Manuela Maria Conceição Ferreira
- Higher School of Health of Viseu, Polytechnic Institute of Viseu, Health Sciences Research Unit: Nursing (UICISA: E/ESEnfC-ESSV/IPV), Viseu, Portugal
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Çatal AT, Cebeci F, Uçak A. Intern nursing students' perceptions of patient safety culture and their experiences with factors affecting the safety of care in hospital settings: A mixed method study. NURSE EDUCATION TODAY 2024; 135:106120. [PMID: 38354429 DOI: 10.1016/j.nedt.2024.106120] [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: 10/25/2023] [Revised: 01/15/2024] [Accepted: 01/30/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Patient safety culture is a globally studied subject as it plays a significant role in preventing and reducing errors. There is limited mixed-method research into the in-depth investigation of intern nurses' views on patient safety in hospital settings and the factors affecting it. OBJECTIVE This study was conducted to determine intern nursing students' perceptions of patient safety culture and their experiences with exploring factors affecting the safety of care in hospital settings. DESIGN AND METHODS A convergent mixed-method design was used. The study group was selected using the purposive sampling method. STROBE and COREQ checklists were followed. The quantitative phase was descriptive and correlational, and the qualitative phase was phenomenological. Quantitative data were collected using a "Personal Information Form" and "Patient Safety Culture Scale" and qualitative data using a "Semi-Structured Interview Form." Mean ± standard deviation, median (min-max), frequency, percentage values, Shapiro-Wilk, and Mann-Whitney U tests were employed to evaluate quantitative data. The inductive content analysis method was used to analyze qualitative data. SETTING AND PARTICIPANTS The study consisted of intern nursing students from a university in the 2020-2021 academic year. The quantitative phase of the research was conducted with 38 and the qualitative phase with nine intern nursing students. In the qualitative phase, the saturation point was taken as a basis. RESULTS In the study, nursing students' perceptions of patient safety culture were high (3.24 ± 0.49; min = 1.88 and max = 4). The results of the qualitative data analysis indicated that the factors affecting patient safety in hospital settings consisted of three themes, namely "health professionals, care environment, and patients and caregivers" and nine subthemes. CONCLUSIONS Intern nursing students had high perceptions of patient safety culture and had highly significant experiences with the factors affecting safe care in hospital settings.
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Affiliation(s)
- Arzu Tat Çatal
- Faculty of Nursing, Surgical Nursing Department, Akdeniz University, 07058 Campus/Antalya, Turkey.
| | - Fatma Cebeci
- Faculty of Nursing, Surgical Nursing Department, Akdeniz University, 07058 Campus/Antalya, Turkey.
| | - Ayşe Uçak
- Faculty of Health Sciences, Department of Nursing, Burdur Mehmet Akif Ersoy University, 15100 Center/Burdur, Turkey.
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Brás CPDC, Ferreira MMC, Figueiredo MDCABD, Duarte JC. Cultura de segurança do doente na prática clínica dos enfermeiros. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6231.3838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Resumo Objetivo: avaliar as caraterísticas psicométricas do Hospital Survey on Patient Safety Culture, caracterizar a cultura de segurança do doente e avaliar a influência das variáveis sociodemográficas e profissionais nas dimensões da cultura de segurança. Método: estudo metodológico, observacional, analítico, transversal, realizado com 360 enfermeiros, utilizando o questionário Hospital Survey on Patient Safety Culture. Os dados foram submetidos à análise descritiva, inferencial e estudos de fiabilidade e validade. Resultados: os enfermeiros possuem em média 42 anos de idade, 19 anos de experiência profissional e são maioritariamente do sexo feminino. Obteve-se boa consistência interna (alfa de Cronbach - 0,83) e índices aceitáveis de qualidade de ajustamento do modelo. O trabalho em equipa dentro das unidades, expetativas do supervisor, feedback e comunicação sobre o erro, foram dimensões que apresentaram scores acima dos 60%. A resposta ao erro não punitiva, frequência da notificação, apoio à segurança pela gestão, dotação de profissionais, apresentaram scores abaixo dos 40%. Estas dimensões são influenciadas pela idade, escolaridade e experiência profissional. Conclusão: as propriedades psicométricas do questionário certificam a sua qualidade. O trabalho em equipa pode ser considerado um fator potenciador da cultura de segurança. Avaliar a cultura de segurança permitiu identificar dimensões problemáticas, possibilitando o planeamento de intervenções futuras.
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Brás CPDC, Ferreira MMC, Figueiredo MDCABD, Duarte JC. Cultura de seguridad del paciente en la práctica clínica de enfermería. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6231.3836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Resumen Objetivo: evaluar las características psicométricas de la Hospital Survey on Patient Safety Culture, caracterizar la cultura de seguridad del paciente y evaluar la influencia de variables sociodemográficas y profesionales en las dimensiones de la cultura de seguridad. Método: estudio metodológico, observacional, analítico, transversal, realizado con 360 enfermeros, utilizando el cuestionario Hospital Survey on Patient Safety Culture. Los datos fueron sometidos a análisis descriptivo e inferencial y estudios de confiabilidad y validez. Resultados: los enfermeros tienen en promedio 42 años de edad, 19 años de experiencia profesional y la mayoría es de sexo femenino. Se obtuvo buena consistencia interna (alfa de Cronbach - 0,83) e índices aceptables de bondad de ajuste del modelo. El trabajo en equipo dentro de las unidades, las expectativas del supervisor, el feedback y la comunicación del error fueron las dimensiones que presentaron puntajes superiores al 60%. La respuesta al error no punitiva, la frecuencia de notificación, el apoyo a la seguridad por parte de los gestores, la dotación de personal, presentaron puntajes por debajo del 40%. Estas dimensiones son influenciadas por la edad, la educación y la experiencia profesional. Conclusión: las propiedades psicométricas del cuestionario certifican su calidad. El trabajo en equipo puede considerarse un factor que potencia la cultura de seguridad. La evaluación de la cultura de seguridad permitió identificar las dimensiones que tenían problemas y poder planificar futuras intervenciones.
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Fuseini AKJ, Teixeira da Costa EIM, de Matos FAS, Merino-Godoy MDLA, Nave F. Patient-Safety Culture among Emergency and Critical Care Nurses in a Maternal and Child Department. Healthcare (Basel) 2023; 11:2770. [PMID: 37893844 PMCID: PMC10606642 DOI: 10.3390/healthcare11202770] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION The quality of healthcare has multiple dimensions, but the issue of patient safety stands out due to the impact it has on health outcomes, particularly on the achievement of the Sustainable Development Goals (SDGs), expressly SDG3. In the services that we propose to study, the patient-safety culture had never been evaluated. AIM To evaluate nurses' perceptions of the patient-safety culture in the Emergency and Critical Care Services of the Maternal and Child Department of a University Hospital and to identify strengths, vulnerabilities, and opportunities for improvement. METHODS This an exploratory, cross-sectional study with a quantitative approach, using the Hospital Survey on Patient Safety Culture as an instrument for data collection. The population were all nurses working in the emergency and critical care services of the maternal and child-health department, constituted, at the time of writing, by 184 nurses, with a response rate of 45.7%. RESULTS Applying the guidelines from the Agency for Healthcare Research and Quality (AHRQ), only teamwork within units had a score greater than 75%. For this reason, it is considered the strength (fortress) in the study. The lowest-rated were non-punitive responses to errors and open communication. CONCLUSION The overall average percentage score is below the benchmark of the AHRQ, indicating that issue of patient safety is not considered a high priority, or that the best strategies to make it visible have not yet been found. One of the important implications of this study is the opportunity to carry out a deep reflection, within the organization, that allows the development of a non-punitive work environment that is open to dialogue, and that allows the provision of safe nursing care.
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Affiliation(s)
- Abdul-Karim Jebuni Fuseini
- Nursing Department, Health School, University of Algarve, 8000 Faro, Portugal (E.I.M.T.d.C.); (F.A.S.d.M.); (F.N.)
| | - Emília Isabel Martins Teixeira da Costa
- Nursing Department, Health School, University of Algarve, 8000 Faro, Portugal (E.I.M.T.d.C.); (F.A.S.d.M.); (F.N.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000 Coimbra, Portugal
| | - Filomena Adelaide Sabino de Matos
- Nursing Department, Health School, University of Algarve, 8000 Faro, Portugal (E.I.M.T.d.C.); (F.A.S.d.M.); (F.N.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000 Coimbra, Portugal
| | | | - Filipe Nave
- Nursing Department, Health School, University of Algarve, 8000 Faro, Portugal (E.I.M.T.d.C.); (F.A.S.d.M.); (F.N.)
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000 Coimbra, Portugal
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Pedroso AC, Fernandes FP, Tuma P, Vernal S, Pellizzari M, Seisdedos MG, Prieto C, Wilckens BO, Villamizar OJS, Olaya LAC, Delgado P, Cendoroglo Neto M. Patient safety culture in South America: a cross-sectional study. BMJ Open Qual 2023; 12:e002362. [PMID: 37802541 PMCID: PMC10565275 DOI: 10.1136/bmjoq-2023-002362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Every year, millions of patients suffer injuries or die due to unsafe and poor-quality healthcare. A culture of safety care is crucial to prevent risks, errors and harm that may result from medical assistance. Measurement of patient safety culture (PSC) identifies strengths and weaknesses, serving as a guide to improvement interventions; nevertheless, there is a lack of studies related to PSC in Latin America. AIM To assess the PSC in South American hospitals. METHODS A multicentre international cross-sectional study was performed between July and September 2021 by the Latin American Alliance of Health Institutions, composed of four hospitals from Argentina, Brazil, Chile and Colombia. The Hospital Survey on Patient Safety Culture (HSOPSC V.1.0) was used. Participation was voluntary. Subgroup analyses were performed to assess the difference between leadership positions and professional categories. RESULTS A total of 5695 records were analysed: a 30.1% response rate (range 25%-55%). The highest percentage of positive responses was observed in items related to patient safety as the top priority (89.2%). Contrarily, the lowest percentage was observed in items regarding their mistakes/failures being recorded (23.8%). The strongest dimensions (average score ≥75%) were organisational learning, teamwork within units and management support for patient safety (82%, 79% and 78%, respectively). The dimensions 'requiring improvement' (average score <50%) were staffing and non-punitive responses to error (41% and 37%, respectively). All mean scores were higher in health workers with a leadership position except for the hospital handoff/transitions item. Significant differences were found by professional categories, mainly between physicians, nurses, and other professionals. CONCLUSION Our findings lead to a better overview of PSC in Latin America, serving as a baseline and benchmarking to facilitate the recognition of weaknesses and to guide quality improvement strategies regionally and globally. Despite South American PSC not being well-exploited, local institutions revealed a strengthened culture of safety care.
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Affiliation(s)
- Aline Cristina Pedroso
- Qualidade e Segurança do Paciente, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Paula Tuma
- Qualidade e Segurança do Paciente, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Sebastian Vernal
- Escritório de Excelência, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | | | - Constanza Prieto
- Clinica Alemana de Santiago SA, Vitacura, Metropolitan Region, Chile
| | | | | | | | - Pedro Delgado
- Latin America and Europe Regions, Institute for Healthcare Improvement, Belfast, UK
| | - Miguel Cendoroglo Neto
- Qualidade e Segurança do Paciente, Hospital Israelita Albert Einstein, São Paulo, Brazil
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Dabaghi S, Zandi M, Ebadi A, Abbaszadeh A, Rohani C. 'Development and psychometric evaluation of the safety feeling scale in adult patients at hospital: Exploratory sequential mixed method'. Nurs Open 2023; 10:6165-6174. [PMID: 37246347 PMCID: PMC10416024 DOI: 10.1002/nop2.1850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/30/2023] Open
Abstract
AIM AND OBJECTIVES This study aimed to develop and examine psychometric properties of the safety feeling scale (SFS) in adult patients to assess their sense of safety during a hospital stay. DESIGN Mixed methods design. A SQUIRE checklist was used. METHODS This is a study with two phases of scale development and evaluation of the psychometric properties of the scale. In the first phase, the concept of 'safety feeling' was analysed using a hybrid model. Thus, a systematic review and then a qualitative study with hospitalized patients (n = 31) were conducted by conventional content analysis. In the psychometric phase, factorial validity, reliability, feasibility, and responsiveness of the scale were evaluated by different tests in various samples. RESULTS After integrating the results of the systematic review and qualitative study, a scale item pool with 84 items was developed. In the psychometric phase, 12 items with four factors were specified; 'effective care,' 'confidence in the healthcare team,' 'emotional enrichment' and 'hygienic facilities,' explaining 51% of the total variance of the scale. They were confirmed by confirmatory factor analysis. Internal consistency and stability of the scale were satisfactory. Feasibility and responsiveness were also acceptable.
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Affiliation(s)
- Sahar Dabaghi
- Department of community health nursing, School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Mitra Zandi
- School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Abbas Ebadi
- Behavioral Sciences Research CenterLife Style Institute, Baqiyatallah University of Medical SciencesTehranIran
- Research Center for Life & Health Sciences & Biotechnology of the PoliceDirection of Health, Rescue & Treatment, Police HeadquarterTehranIran
| | - Abbas Abbaszadeh
- Nursing and Midwifery SchoolShahid Beheshti University of Medical SciencesTehranIran
| | - Camelia Rohani
- Department of Health Care Sciences, Palliative Research CenterMarie Cederschiöld Högskola, Campus ErstaStockholmSweden
- Community Health Nursing Department, School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
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Bongongo T, Govender I, Olowa SN, Phukuta NSJ, Nzaumvila DK. Level of patient safety culture among public healthcare professionals in Pretoria. S Afr Fam Pract (2004) 2023; 65:e1-e6. [PMID: 37265136 DOI: 10.4102/safp.v65i1.5640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Patient safety culture (PSC) norms set within an organisation prevent harm during medical care. This study assessed the level of PSC among public healthcare professionals (HCPs) in Pretoria, South Africa. METHODS A multi-centre cross-sectional study conducted in three hospitals and 25 clinics in regions 1 and 2 of Pretoria, using a self-administered questionnaire adapted from the Hospital Survey on Patient Safety Culture. Using the Raosoft online sample size formula, from 1238 public HCPs identified, the sample size was calculated at 294; this expanded to 319 as a result of respondents' willingness to participate in the study. RESULTS Of the 319 respondents with a mean age of 39.9 years, the minimum and maximum ages were 22 and 66 years, respectively. The age group of 30-39 years had the highest participation rate (17.6%). Most respondents (41.1%) came from the Odi district hospital and there were more women (78.1%) and nurses (49.2%). Positive attitudes were found for all PSC components, with staff education and training scoring highest (98.7%). Patient safety culture received a satisfactory rating from HCPs from the targeted facilities. CONCLUSION This study showed that public HCPs in Pretoria's regions 1 and 2 have a good PSC, particularly among nurses, professionals with more experience, and at primary care level.Contribution: To maintain or increase awareness of this concept among HCPs, the study advocates a PSC programme as well as ongoing education that can be supported by district and facility managers.
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Affiliation(s)
- Tombo Bongongo
- Department of Family Medicine and Primary Health Care, Faculty of Medicine, Sefako Makgatho Health Sciences University, Pretoria.
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Contribution of nursing students to clinical settings: A multi center cross sectional study. Nurse Educ Pract 2023; 68:103601. [PMID: 36921409 DOI: 10.1016/j.nepr.2023.103601] [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: 11/11/2022] [Revised: 02/22/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023]
Abstract
AIMS To describe the contribution of nursing students to clinical settings based on the perceptions of nurse preceptors and to examine whether certain characteristics of nurses' professional activity are associated with a positive perception of nursing students. BACKGROUND Most clinical agencies receive many nursing students each year, who acquire clinical competencies under the guidance of a registered nurse preceptor. However, there is limited evidence of the contributions made by nursing students during clinical placements. METHODS A multi-center cross-sectional study was carried out between June and December 2019. A convenience sample of Registered Nurses (n = 927) was recruited from four public hospitals in Spain. The Nursing Student Contributions to Clinical Settings' questionnaire was used. In addition, sociodemographic, work and teaching activity variables were collected. Multivariable logistic regression was used to determine the variables associated with positive student contributions. RESULTS The nursing student contributions were deemed favorable by 70.7% of the nurse preceptors, mainly because the nursing students are future professionals who know the center, support the development of the nurses' teaching role and constitute a link between the health center and the university. Certain professional characteristics of the Registered Nurses were significantly associated with a positive perception of the contributions of nursing students: having daily coffee breaks (Odds ratio: 2.60; 95% Confidence interval:1.27-5.32), high levels of professional satisfaction (Odds ratio: 2.13; 95% Confidence interval:1.21-3.75) and work in medical-surgical units (Odds ratio: 1.62; 95% Confidence interval: 1.08-2.41). In contrast, nurses with greater work experience (≥ 30 years) (Odds ratio: 0.48; 95% Confidence interval: 0.27-0.85) and who worked at units where 10 or more students perform clinical practice (Odds ratio: 0.57; 95% Confidence interval: 0.36-0.90) were associated with a lower probability of positive perceptions. CONCLUSIONS In Spain, the contributions made by nursing students to clinical settings are favorable, both for the nursing profession and for healthcare institutions. Their contributions are influenced by the professional characteristics of the Registered Nurses, as well as the environment and the teaching activity within the units.
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Despott R, Sultana J, Camilleri L, Vella Szij J, Serracino Inglott A. Risk management of medication errors: a novel conceptual framework. Expert Opin Pharmacother 2023; 24:523-534. [PMID: 36794331 DOI: 10.1080/14656566.2023.2178899] [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: 02/17/2023]
Abstract
BACKGROUND Medication error is a common cause of patient harm. The study aims to propose a way to manage the risk of medication errors in a novel way, by identifying practice areas where mitigating patient harm should be prioritized using a risk management approach. METHODS Suspected Adverse Drug Reactions (sADRs) in Eudravigilance database over three years were reviewed to identify preventable medication errors. These were classified using a new method based upon the root cause underlying pharmacotherapeutic failure. The correlation between severity of harm and type of medication error, and other clinical parameters was investigated. RESULTS Overall, 2294 medication errors were identified from Eudravigilance, of which 1300 (57%) were due to pharmacotherapeutic failure. Most cases of preventable medication error involved prescribing (41%) and administration (39%). The variables which significantly predicted severity of medication errors were pharmacological group, patient age, number of drugs prescribed, and route of administration. The drug classes most strongly associated with harm included cardiac drugs, opioids, hypoglycaemics, antipsychotics, sedatives, and antithrombotic agents. CONCLUSION The findings of this study highlight the feasibility of using a novel conceptual framework to identify areas of practice at risk of pharmacotherapeutic failure where Interventions by healthcare professionals in these areas are most likely to improve medication safety.
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Affiliation(s)
| | - Janet Sultana
- Pharmacy Department, Mater Dei Hospital, Msida, Malta.,Exeter College of Medicine and Health, University of Exeter, Exeter UK
| | - Liberato Camilleri
- Department of Statistics and Operations Research, University of Malta, Msida, Malta
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Brás CPDC, Ferreira MMC, de Figueiredo MDCAB, Duarte JC. Patient safety culture in nurses' clinical practice. Rev Lat Am Enfermagem 2023; 31:e3837. [PMID: 36995849 PMCID: PMC10077844 DOI: 10.1590/1518-8345.6231.3837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/07/2022] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE to assess the psychometric characteristics of the Hospital Survey on Patient Safety Culture, to characterize the patient safety culture, and to assess the influence of the sociodemographic and professional variables on the safety culture dimensions. METHOD a methodological, observational, analytical and cross-sectional study conducted with 360 nurses in which the Hospital Survey on Patient Safety Culture questionnaire was used. The data were submitted to descriptive and inferential analysis, as well as to feasibility and validity studies. RESULTS the nurses' mean age is 42 years old, their mean time of professional experience is 19 years, and they are mostly female. Good internal consistency was obtained (Cronbach's alpha: 0.83), as well as acceptable model fit quality indices. Teamwork within units, Supervisor expectations and Feedback and communication about errors were the dimensions that obtained scores above 60%. Non-punitive response to error, Frequency of events reported, Support for patient safety and Staffing presented scores below 40%. These dimensions are influenced by age, schooling level and professional experience. CONCLUSION the psychometric properties of the questionnaire certify its good quality. Teamwork can be considered as an enhancing factor for the safety culture. Assessing the safety culture allowed identifying problematic dimensions, thus enabling planning of future interventions.
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Affiliation(s)
- Cláudia Patrícia da Costa Brás
- Escola Superior de Enfermagem de Coimbra, Unidade de Investigação em Ciências da Saúde (UICISA: E), Coimbra, PT, Portugal
| | - Manuela Maria Conceição Ferreira
- Escola Superior de Saúde de Viseu - Instituto Politécnico de Viseu, Unidade de Investigação em Ciências da Saúde (UICISA: E/ESEnfC - ESSV/IPV), Viseu, PT, Portugal
| | | | - João Carvalho Duarte
- Escola Superior de Saúde de Viseu - Instituto Politécnico de Viseu, Unidade de Investigação em Ciências da Saúde (UICISA: E/ESEnfC - ESSV/IPV), Viseu, PT, Portugal
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Keyvanloo Shahrestanaki S, Rafii F, Najafi Ghezeljeh* T, Ashghali Farahani M, Amrollah Majdabadi Kohne Z. Concept analysis of patient safety in home care: a hybrid model. BMJ Open Qual 2022; 11:bmjoq-2022-002077. [PMID: 36521926 PMCID: PMC9756164 DOI: 10.1136/bmjoq-2022-002077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/16/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Patient safety in home care is a fundamental and complex concept in nursing. This concept includes a number of challenges in patient care. Studies have shown that there is no clear and uniform definition for this concept. OBJECTIVE The objective of the present study was to analyse patient safety in home care in Iran. METHODS The study was done using a hybrid model at three phases, including theoretical, field work and the final analysis. We searched valid databases including MEDLIN and CINHAL; electronic references including Web of Science, Scopus, Ovid, ProQuest, PubMed and Persian databases including Magiran, IranDoc and SID during 2008-2022, using these Persian and English keywords: Patient Safety, Safety, Home Care Service, Domiciliary Care, Home Care and Home Health Care. A total of 16 articles were searched in the theoretical phase and then analysed by content analysis. In field work phase, nine participants were interviewed (nurse, family and patient) and then the interviews were analysed by the content analysis method. In the final analysis phase, a general analysis of the previous two phases was performed and after determining the attributes, antecedents and consequences, a final definition of patient safety in home care in Iran was presented. FINDINGS Based on different studies, patient safety in home care is a multifaceted concept, which encompasses physical, mental, social and practical dimensions. Evaluation, prevention, participation and commitment to the safety culture are the core features of this concept. The patient care concept depends on the commitment of the involved participants, adequate resources, environmental conditions, support of the involved centres (home care agency, hospital and the insurance), self-efficacy and the ability of the caregivers (nurses). CONCLUSION Defining the concept of patient safety in home care provides a basis for the development of a safe patient care system at home. This concept analysis for patient safety in home care could be a guide for future studies.
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Affiliation(s)
| | - Forough Rafii
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi Ghezeljeh*
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Ashghali Farahani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Camacho-Rodríguez DE, Carrasquilla-Baza DA, Dominguez-Cancino KA, Palmieri PA. Patient Safety Culture in Latin American Hospitals: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14380. [PMID: 36361273 PMCID: PMC9658502 DOI: 10.3390/ijerph192114380] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Adverse events in hospitals are prevented through risk reduction and reliable processes. Highly reliable hospitals are grounded by a robust patient safety culture with effective communication, leadership, teamwork, error reporting, continuous improvement, and organizational learning. Although hospitals regularly measure their patient safety culture for strengths and weaknesses, there have been no systematic reviews with meta-analyses reported from Latin America. PURPOSE Our systematic review aims to produce evidence about the status of patient safety culture in Latin American hospitals from studies using the Hospital Survey on Patient Safety Culture (HSOPSC). METHODS This systematic review was guided by the JBI guidelines for evidence synthesis. Four databases were systematically searched for studies from 2011 to 2021 originating in Latin America. Studies identified for inclusion were assessed for methodological quality and risk of bias. Descriptive and inferential statistics, including meta-analysis for professional subgroups and meta-regression for subgroup effect, were calculated. RESULTS In total, 30 studies from five countries-Argentina (1), Brazil (22), Colombia (3), Mexico (3), and Peru (1)-were included in the review, with 10,915 participants, consisting primarily of nursing staff (93%). The HSOPSC dimensions most positive for patient safety culture were "organizational learning: continuous improvement" and "teamwork within units", while the least positive were "nonpunitive response to error" and "staffing". Overall, there was a low positive perception (48%) of patient safety culture as a global measure (95% CI, 44.53-51.60), and a significant difference was observed for physicians who had a higher positive perception than nurses (59.84; 95% CI, 56.02-63.66). CONCLUSIONS Patient safety culture is a relatively unknown or unmeasured concept in most Latin American countries. Health professional programs need to build patient safety content into curriculums with an emphasis on developing skills in communication, leadership, and teamwork. Despite international accreditation penetration in the region, there were surprisingly few studies from countries with accredited hospitals. Patient safety culture needs to be a priority for hospitals in Latin America through health policies requiring annual assessments to identify weaknesses for quality improvement initiatives.
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Affiliation(s)
- Doriam E. Camacho-Rodríguez
- Facultad de Enfermería, Universidad Cooperativa de Colombia, Santa Marta 470002, Colombia
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
| | - Deibys A. Carrasquilla-Baza
- Facultad de Enfermería, Universidad Cooperativa de Colombia, Santa Marta 470002, Colombia
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
| | - Karen A. Dominguez-Cancino
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
- Addiction Study Program, Université de Sherbrooke, 150, Place Charles-Le Moyne, Bureau 200, Longueuil, QC J4K 0A8, Canada
- Escuela de Salud Pública, Universidad de Chile, Av. Independencia 939, Independencia, Santiago de Chile 8380453, Chile
| | - Patrick A. Palmieri
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
- South American Center for Qualitative Research, Universidad Norbert Wiener, Av. Arequipa 444, Lima 15046, Peru
- College of Graduate Health Studies, A.T. Still University, 800 West Jefferson Street, Kirksville, MO 63501, USA
- Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030, USA
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Kaware MS, Ibrahim MI, Shafei MN, Mohd Hairon S, Abdullahi AU. Patient Safety Culture and Its Associated Factors: A Situational Analysis among Nurses in Katsina Public Hospitals, Northwest Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063305. [PMID: 35328993 PMCID: PMC8951849 DOI: 10.3390/ijerph19063305] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
Background: Patient safety involves identifying, assessing, and managing patient-related risks and occurrences to improve patient care and reduce patient harm. In Nigeria, there is a lack of studies on patient safety culture, especially in the northern part of the country. This study aimed to determine the levels and factors that contribute to nurses’ negative perceptions of patient safety culture in public health facilities. Methodology: A total of 460 nurses were surveyed across 21 secondary health facilities using the Hospital Survey on Patient Safety Culture, and the response rate was 93.5%. Descriptive statistics and multiple logistic regression were used to analyze the data. Results: The results showed that 59.8% of the respondents were female, and 42.6% were within the age range of 30–39 years old. Most of them (48.3%) had spent 1–5 years working in the hospital. Three out of 12 composite measures had higher negative responses (staffing—30.5%, non-punitive response to error—42.8%, and frequency of events reported—43.1%). A multiple logistic regression analysis affirmed that all three variables, in addition to organizational learning, were significant associated with overall negative perceptions of patient safety culture, with 3.15, 1.84, 2.26, and 2.39 odds ratios, respectively. Conclusion: The results revealed that four critical areas of patient safety required improvement; therefore, intervention is recommended to minimize unnecessary patient harm and medical expenses.
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Affiliation(s)
- Musa Sani Kaware
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (M.S.K.); (M.N.S.); (S.M.H.)
- Department of Community Medicine, College of Health Sciences, Umaru Musa Yar’adua University, Katsina 820101, Katsina State, Nigeria;
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (M.S.K.); (M.N.S.); (S.M.H.)
- Correspondence: ; Tel.: +60-97676621
| | - Mohd Nazri Shafei
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (M.S.K.); (M.N.S.); (S.M.H.)
| | - Suhaily Mohd Hairon
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (M.S.K.); (M.N.S.); (S.M.H.)
| | - Abduljaleel Umar Abdullahi
- Department of Community Medicine, College of Health Sciences, Umaru Musa Yar’adua University, Katsina 820101, Katsina State, Nigeria;
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