Abstract
BackgroundHuman failure and a lack of effective communication are the main reasons for preventable adverse events, compromising patient safety in obstetrics. In order to improve safety, team and communication interventions have been implemented but lack feasibility in obstetric care. Psychological models such as the health action process approach might help to improve interventions.MethodsIn a cross-sectional online survey with N = 129 healthcare workers (Study 1) and a paper-pencil survey with N = 137 obstetric healthcare workers at two obstetric university hospitals (Study 2), associations of social-cognitive variables were tested in a path analysis and a multiple regression. Preliminary results informed a communication training for all obstetric healthcare workers. A repeated-measures MANOVA was used to compare pre- and post-intervention data.ResultsSocial-cognitive variables were associated according to model suggestions (β = –0.26 to 0.45, p < 0.05) except for planning in the first study. Triggers of adverse events were associated (β = –0.41 to 0.24, p < 0.05) with communication behavior (Study 2), action self-efficacy and planning (Study 1), as well as barriers to effective communication (both studies). The intervention was rated positively (M = 3.3/4). Afterward, fewer triggers were reported and coping self-efficacy increased. There were group differences regarding hospital, experience, and time.DiscussionThe health action process approach was examined in the context of safe communication in obstetrics and can be used to inform interventions. A theory-based, short training was feasible and acceptable. Perceived patient safety improved but communication behavior did not. Future research should aim to test a more comprehensive psychological communication intervention in a thorough RCT design.
Highlights
In the last decades, research in health-related fields has increasingly focused on patient safety, defined by the absence of harmful incidents of patient harm that could have been avoided under given circumstances (Runciman et al, 2009)
We aim to examine the health action process approach (HAPA) model in the context of professional communication as a health behavior in obstetrics, bringing new insights into mechanisms of communication
Pre- and post-test data were assessed but no control group was realized due to ethical concerns. Both studies were conducted within the research project “TeamBaby – Safe, digitally supported communication in obstetrics and gynecology” (ClinicalTrials.gov Identifier: NCT03855735) which aims to improve communication among healthcare workers (HCW) and mothersto-be and enhance patient safety in obstetrics
Summary
Research in health-related fields has increasingly focused on patient safety, defined by the absence of harmful incidents of patient harm that could have been avoided under given circumstances (Runciman et al, 2009) These adverse events are usually rare, they can lead to lasting disabilities and contribute to patient death, especially in emergency medicine (Pettker, 2017; Eulmesekian et al, 2020). Human failure and a lack of effective communication are the main reasons for preventable adverse events, compromising patient safety in obstetrics. In order to improve safety, team and communication interventions have been implemented but lack feasibility in obstetric care Psychological models such as the health action process approach might help to improve interventions
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