Advancing Parkinson's Care and Patient Safety Through CMS's Age-Friendly Hospital Measure.

There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective development and deployment strategies are lacking. There is a large gap between the postulated and empirically demonstrated benefits of eHealth technologies. In addition, there is a lack of robust research on the risks of implementing these technologies and their cost-effectiveness has yet to be demonstrated, despite being frequently promoted by policymakers and "techno-enthusiasts" as if this was a given. In the light of the paucity of evidence in relation to improvements in patient outcomes, as well as the lack of evidence on their cost-effectiveness, it is vital that future eHealth technologies are evaluated against a comprehensive set of measures, ideally throughout all stages of the technology's life cycle. Such evaluation should be characterised by careful attention to socio-technical factors to maximise the likelihood of successful implementation and adoption.

Background Electronic prescribing (e-prescribing) is a potentially important intervention that can be used to reduce errors. It provides many potential benefits over handwritten medication prescriptions, including standardization, legibility, audit trails, and decision support. Electronic health record (EHR) and e-prescribing systems may greatly enhance communication and improve the quality and safety of care. Objectives Our aim is to investigate physician's opinions about the influence of electronic prescriptions on patient safety and quality of care. Methods This study extends the technology acceptance model to analyze the acceptance of e-prescribing and adds an understanding of what kind of impact the external variables (patient identification and the interoperability of applications) have on physicians' individual work performance (i.e., patient safety and quality of care). The empirical analysis uses data from surveys conducted in 2012 and 2014 in Finland. The participants were physicians, and e-prescribing was the only method that could be used for prescribing medication when these studies were conducted. Results Physicians' perceived usefulness of e-prescribing was significantly associated with patient safety and quality of care. The interoperability of an EHR had a significant effect on both the perceived ease of use and perceived usefulness of e-prescribing. The findings show that experience with an e-prescribing system has a positive effect on participants' perceived ease of use and perceived usefulness of e-prescribing. Conclusion This study highlights potential safety and efficiency benefits associated with integrated health information technology in health care. The perceived usefulness of e-prescribing affected physicians' opinions on patient safety and quality of care.

Patient safety management in the health services- what do patients want?

Global control of health-care associated infections

Safety in health care today: more than just freedom from errors and accidents?

To explore the perspectives and experiences of nurse instructors and clinical nurses regarding the assessment of safe nursing care and its components in clinical practice. Safe nursing care is a key aspect of risk management in the healthcare system. The assessment of safe nursing care and identification of its components are primary steps to establish patient safety and risk management and enhance the quality of care in clinical practice. This was an interview study, with qualitative content analysis. Semi-structured interviews were conducted with 16 nurse instructors and clinical nurses including nurse managers chosen by purposive sampling based on theoretical saturation. Data collection and analysis were carried out simultaneously until data saturation was reached. Data analysis led to the extraction of four main themes: holistic assessment of safe nursing care; team working and assessment of safe nursing care; ethical issues; and challenges of safe nursing care assessment. Identifying these four components in the assessment of safe nursing care offers a contribution to the understanding of the elements of safe care assessment and the potential for improved patient safety. Safe care management requires the accurate and reliable assessment of safe nursing care and the need for strategies for reporting actual or potential unsafe care and errors to ensure patient safety.

Patient safety, including medicine safety, is not a novel thing in nursing, when already Florence Nightingale recognised in her textbook Notes on Nursing that the first demand for a hospital is that it does not cause harm to the patient. Patient safety is a central part of the quality of the health care. Safe nursing is effective; it is implemented correctly and at right time. Patient safety means that patient get the care he or she needs and is correct for him or her and it causes as little harm as possible. Patient safety includes safety of care, safe medication and device safety. One of the most important examples of patient's safety is safe medication. The Five Rights of Medication Administration is very familiar to each of us, nursing education in our background. It is one of the recommendations to reduce medication errors and harm is to use the ‘five rights’: the right patient, the right drug, the right dose, the right route and the right time. Improving patient safety by reducing the incidence of preventable adverse events is a global challenge; however, the progress has been quite slow. In European Union to safeguard public health, a directive 1 and a regulation 2 were given for the regulation of medicinal products 1, 2. In addition, the directive aimed also not to impede the free movement of safe medicinal products within the Union. In European Union level, a joint action on patient safety and quality of care (PaSQ) was introduced in 2012, with the focus to improve patient safety and quality of care through sharing of information, experience and the implementation of good practices. Globally developing patient safety has been one of the focuses in WHO, which published in 2013 Patient Safety. World alliance for patient safety and in 2017, the World Health Organization (WHO) launched a third global patient safety challenge ‘Medication Without Harm’, aimed at improving medication safety, on the basis that medication errors are a leading cause of injury and avoidable harm in healthcare systems globally. Patient safety has been a focus of several research projects. International study 3 about nurses’ reports of working conditions and hospital quality of care in 12 countries in Europe and United States reported, that while most nurses did not give their hospitals poor grades on patient safety, many doubted that safety was a management priority. For example, 7% of participant Finnish nurses perceived patient safety as poor or decreased. Nurses reported that important nursing tasks were often left undone because of lack of time and indicated that adverse events were not uncommon. The research group 4 also found out that each increase of one patient per nurse is associated with a 7% increase in the likelihood of a surgical patient dying within 30 days of admission, whereas each 10% increase in the per cent of bachelor's degree nurses in a hospital is associated with a 7% decrease in this likelihood. In Finland, Merja Sahlström's doctoral research 5 results indicated very recently that about one in four patients has met an adverse event. On the other hand, patients felt safe during their care period and most of them evaluated the level of patient safety as very good or excellent, although 21.9% of them rated it lower. The same research reported that patient safety experts were more critical and considered patient safety to be primarily at acceptable (average) level. The harm caused by an adverse event is diverse, starting from those events and errors that do not cause any harm to those, which lead to patient's death. The research evidence indicates that most of the events or errors are so called ‘close calls’, events that do not cause any harm for the patient, but for about 6% of the events causes severe harm or even death. It is not enough just to report the adverse events, but also develop interventions and research-based evidence on how to avoid them. One example is the study of 6 in which medication errors and improved medication safety were focused. The basis of improved medication safety demands a clearly defined and standardised medication management process as well as describing the process more clearly, which also helps in standardising processes. Knowledge and skills of healthcare professionals should be developed focusing also on how to act as a multiprofessional team. Also, considering the advantages the new technological solutions add to the medication safety should be acknowledged. The study also showed that computerised patient safety incident reporting systems can provide important qualitative information to improve medication process to be safer. Although the topic of the articles in this journal does not focus to the patient safety, it can be acknowledged that the new knowledge they provide will all improve patient safety. Especially when implemented in the practice – in clinical world, in education or in leadership, the new study results will give evidence for research-based nursing and for improved patient safety.

Overview of progress in patient safety

Aligning Healthcare Safety and Quality Competencies: Quality and Safety Education for Nurses (QSEN), The Joint Commission, and American Nurses Credentialing Center (ANCC) Magnet® Standards Crosswalk

The role of safety leadership in nursing management during the pandemic

IntroductionSurgical care has been a vital part of healthcare services worldwide. Several patient safety measures have been adopted universally in the operating room (OR) before, during, and following surgical procedures. Despite this, errors or near misses still occur. Nurses in the OR have a pivotal role in the identification of factors that may impact patient safety and quality of care. Therefore, exploring the OR nurses’ understanding of their roles and responsibilities for patient care and safety in the intraoperative practice, which could lead to optimal patient safety, is essential.ObjectiveThis study explored the understanding of OR nurses regarding their roles and responsibilities for patient care and safety measures in the intraoperative practice.MethodsThe study was conducted in one of the tertiary care hospitals in the United Arab Emirates. Qualitative, descriptive, exploratory research design was utilized. The data were collected using semi-structured face to face interviews. Purposive sampling included eight nurses. Data analysis was performed following Colaizzi's seven-step strategy.ResultsSeven emerging themes were identified. The main themes are: patient safety, preoperative preparation, standardization of practice, time management, staffing appropriateness, staff education and communication, and support to the patient in the OR.ConclusionOR nurse leaders may take into consideration the current findings as a reference for quality improvement projects in the hospital, considering the specific characteristics of each local setting. Although the participants consider that the environment is safe and the quality of care is high in the study setting, there is still room for improvement on workflows and processes. OR workflow should be improved especially by addressing the potential patient safety issues.

Transitions of care after cancer treatment pose a major challenge for patient safety as adverse events and unplanned healthcare utilization occur frequently. At this point, patient and family engagement (PFE) is particularly valuable since patients and their families experience various challenges along this pathway, such as changing roles and recurrent needs to navigate across structural gaps between different services. However, there is currently a lack of evidence on the impact of PFE on patient safety in transitions after cancer treatment. To systematically review and synthesize evidence on effects of different PFE interventions on patient safety in the transition of care after cancer treatment. This protocol for a systematic review with meta-analysis follows PRISMA-P guidelines. A comprehensive database search will be conducted in MEDLINE, EMBASE, CENTRAL, CINAHL, and APA PsycInfo. Trial registries and grey literature will be searched, forward and backward citation tracking will be performed. Trials with prospective, longitudinal, interventional study designs will be included if they evaluate PFE interventions on patient safety outcomes (primary outcomes: healthcare utilization, patient harm, adherence, patient experience; secondary: quality of life, distress); eligible studies need to survey patients with any oncological disease during or after transition following cancer treatment. Results will be synthesized narratively and meta-analytically using a random-effects model. Risk of bias will be assessed using the Cochrane RoB-2 and revised JBI critical appraisal tool. The certainty of evidence will be judged according to the GRADE approach. Robust evidence of effectiveness is needed to establish PFE interventions for patient safety in care transitions for oncological patients. This review will allow evidence-based conclusions about types and effects of different PFE interventions for transitional safety in oncology care and inform stakeholders in designing sustainable PFE activities. PROSPERO (CRD42024546938), OSF (doi.org/10.17605/OSF.IO/9XAMU).

Improving the practice environment, quality of care and patient safety are global health priorities. In South Africa, quality of care and patient safety are among the top goals of the National Department of Health; nevertheless, empirical data regarding the condition of the nursing practice environment, quality of care and patient safety in public hospitals is lacking.AimThis study examined nurses’ perceptions of the practice environment, quality of care and patient safety across four hospital levels (central, tertiary, provincial and district) within the public health sector of South Africa.MethodsThis was a cross-sectional survey design. We used multi-phase sampling to recruit all categories of nursing staff from central (n = 408), tertiary (n = 254), provincial (n = 401) and district (n = 244 [large n = 81; medium n = 83 and small n = 80]) public hospitals in all nine provinces of South Africa. After ethical approval, a self-reported questionnaire with subscales on the practice environment, quality of care and patient safety was administered. Data was collected from April 2021 to June 2022, with a response rate of 43.1%. ANOVA type Hierarchical Linear Modelling (HLM) was used to present the differences in nurses’ perceptions across four hospital levels.ResultsNurses rated the overall practice environment as poor (M = 2.46; SD = 0.65), especially with regard to the subscales of nurse participation in hospital affairs (M = 2.22; SD = 0.76), staffing and resource adequacy (M = 2.23; SD = 0.80), and nurse leadership, management, and support of nurses (M = 2.39; SD = 0.81). One-fifth (19.59%; n = 248) of nurses rated the overall grade of patient safety in their units as poor or failing, and more than one third (38.45%; n = 486) reported that the quality of care delivered to patient was fair or poor. Statistical and practical significant results indicated that central hospitals most often presented more positive perceptions of the practice environment, quality of care and patient safety, while small district hospitals often presented the most negative. The practice environment was most highly correlated with quality of care and patient safety outcomes.ConclusionThere is a need to strengthen compliance with existing policies that enhance quality of care and patient safety. This includes the need to create positive practice environments in all public hospitals, but with an increased focus on smaller hospital settings.

Minimum nurse staffing policy intervention in Queensland Australia improved nurse wellbeing and patient safety: A quasi-experimental intervention study.

Patient safety concerns can help minimize the risk of KTD, reduce the occurrence of medical disputes, reduce conflicts between health workers and patients, reduce the lawsuits process, and dismiss allegations of malpractice which is increasing lately. The achievement of a good patient culture is done by building an understanding of the norms, beliefs, attitudes, and values that are important to nursing organizations. The systematic review of this study is aimed at identifying patient safety measures implemented by different countries to look at the effectiveness of patient safety culture in primary health care in global coverage. This research uses systematic review methods. Searching for journals was conducted in three well-known journals such as Proquest, ScienceDirect, and Scopus in the 2015-2021 publishing year. The term used is patient safety in the primary health care area and the community, as well as efforts made. Research on the database identified 7,967 articles to be filtered. After sorting and verifying the paper, data was taken from 12 papers explaining the culture of patient safety in primary health care. The articles taken have global coverage with research originating in several countries namely; Manchester, Sweden, Yemen, Lebanon, Germany, and Brazil. Characteristics of the study are grouped into the following themes: Patient safety in primary health care, and patient safety events in primary health care, Measurement of patient safety in primary health care, and Methods/ efforts to improve patient safety in primary health care. Tools that are used to measure patient safety, in general, are SAQ (Safety Attitudes Questionnaire), MOSPC (Medical Office Survey on Patient Safety Culture), and SOPS(Survey on Patient Safety Culture). This systematic review shows that many measurements can be taken to identify patient safety culture applications. Several efforts can be made to improve patient safety application, one of the important efforts in improving patient safety is improving knowledge. Education is an important step for the best patient safety intervention efforts. One of the programs that can be useful for the development of patient safety is the CUSP (Comprehensive Unit-based Safety Program) program.