A Comparative Study of Compliance with Select Parameters of Patient Safety among Nurses and Doctors in Emergency, Intensive Care Unit, and a Ward of a Tertiary Care Hospital

Abstract

Abstract Background: Patient safety is a critical component of health-care quality. Population-based studies from a number of nations around the world have consistently demonstrated unacceptably high rates of medical injury and preventable deaths. There is a need to capture these mistakes, identify compliance with standard operating procedures (SOPs) regarding patient safety, and not only learn from them but also to share them with others so that such mistakes are prevented. Methodology: An observational study was carried out in the emergency department, inpatient area, and intensive care units (ICUs) for 3 months each. The checklist had various parameters such as medication errors, correct patient identification, surgery, hospital-acquired infection, handover take over, patient care, and equipment upkeep. Results: Regarding the compliance of medication among nurses, expiry date was checked more frequently in the ICU setting, and pharmacological name was checked before injection more frequently in wards and ICU than in emergency. Compliance with handwashing/sanitizing and adherence to the WHO recommendations among nurses as well as doctors is more in the ICU setting while moving from one patient to another and is statistically significant. The present study revealed that compliance about biomedical waste management was better among nursing staff than physicians. This study found better communication among nursing staff as well as doctors about patient details at the time of shift change in ICUs as well as while shifting patients from one area to another, and this is statistically significant. It was found that records of adverse events are better maintained in intensive care areas than in wards and emergency. Call book register is not being maintained in emergency, and both were statistically significant. The nurses blamed the shortage of staff as the primary reason for noncompliance and partial compliance to SOPs. The hospital under study was grossly deficient vis-a-vis nursing staffing norms as many positions were vacant. Conclusion: There is better compliance with SOPs regarding medication administration, hand hygiene, hospital infection control practices, correct patient identification, handoffs, maintenance of records regarding adverse events, and maintenance of call book register in intensive care settings than in emergency and wards, which is in line with the concept of progressive patient care. Compliance is better among nursing staff as compared to doctors which can be explained by better attitude among nursing staff. The vacant positions of nursing staff need to be filled, which can have a good impact on adherence to SOPs.