Patient Safety Concepts Research Articles

Knowledge, Attitudes of Nurses with Implementation of Patient Safety in Undata General Hospital of Central Sulawesi Province

The American Hospital Association (AHA) Board of Trustees stated that patient safety is a strategic priority. In 2004, the World Health Organization (WHO) launched the World Alliance for Patient Safety, a joint program with various countries to improve patient safety in hospitals. The purpose of this study is to know the relationship between knowledge and attitudes of nurses with the implementation of patient safety in Undata General Hospital of Central Sulawesi Province. The type of this research is quantitative with cross sectional approach-based analytical design. The population in this study was the team leaders and implementing nurses in the rooms of Teratai and Catelia pavilions as many as 52 people. The results of Chi Square test with a confidence level of 95% showedthe result of statistical test onthe knowledge of nurses concerning the implementation of patient safety was p=0.021 (p value <0.05) and the result of statistical test on the attitudes of nurses concerning the implementation of patient safety was p=0.025 (p value < 0.05). The conclusion obtained is that there is a relationship between knowledge and attitude of nurses with the implementation of patient safety in Inpatient Wards of Central Sulawesi Province’s Undata General Hospital. The hospital is expected to continuously carry out socialization, organizingbetter in-depth training on the concept of patient safety by emphasizing the importance of the patient safety system.

The attitudes of Korean medical students toward patient safety.

PurposeThis study investigated the attitudes of Korean medical students about patient safety to determine which perspectives required increased focus in terms of educational development.MethodsAttitudes were assessed using the Patient Safety Questionnaire, a tool designed to measure attitudes toward patient safety among medical students. Questionnaires were distributed to 580 clinical year students across four medical schools in December 2018.ResultsA total of 300 returned questionnaires were used in the final analysis. More than half of all respondents agreed (i.e., gave more than 4 out of 7 points) with most items and thoroughly considered the concept of patient safety. However, many students misperceived several items (e.g., professional incompetence as a cause of errors, disclosure responsibility, the importance of patient safety in the curriculum, and situational awareness).ConclusionAttitudes toward patient safety are highly important due to their substantial impacts on behavioral decisions in the clinical setting. As such, patient safety education should be designed to place greater emphasis on proper attitude. This study’s findings should be useful for medical instructors who wish to determine the appropriate areas of curricular focus.

IS PATIENT SAFETY AT THE HEART OF MEDICAL EDUCATION IN INDONESIA? REFLECTION ON THE IMPACT OF THE NATIONAL EXAMINATION

ABSTRACT Background: National examinations in Indonesia (UKMPPD) has been implemented since 2007 as a quality assurance method for medical graduates and medical schools. The impact of UKMPPD has been studied since then, where one of the consequences were related to how it affected medical education and curricula. This study explored the consequences of UKMPPD, focusing on how the students, teachers, and medical schools’ leaders relate the examination with patient care. This study aimed to explore the impact of UKMPPD on medical education, which focusing on the issue of patient safety. Methods: This study was part of a doctoral project, using a qualitative method with a modified grounded theory approach. The perspectives of multiple stakeholders on the impact of the UKMPPD were explored using interview and focus groups. Interviews were conducted with medical schools’ representatives (vice deans/ programme directors), while focus groups were conducted with teachers and students. A sampling framework was used by considering the characteristics of Indonesian medical schools based on region, accreditation status, and ownership (public/ private). Data was analysed using open coding and thematic framework as part of the iterative process. Results: The UKMPPD affected how the stakeholders viewed this high-stakes examination and the education delivered in their medical schools. One of the consequences revealed how stakeholders viewed the UKMPPD and its impact on patient care. Participants viewed the UKMPPD as a method of preparation for graduates’ real clinical practice. The lack of reference for patient safety as the impact of the UKMPPD in this study showed that there were missing links in how stakeholders perceived the examination as part of quality assurance in health care. Conclusion: The UKMPPD as a high-stakes examination has a powerful impact in changing educational policy and programmes in Indonesia. However, in Indonesia, the examination brought in the reflection on how the “patient” element was lacking from medical education. This research offers an insight on the concept of patient safety in Indonesia and how the stakeholders could approach the issue. Keywords: UKMPPD, national licensing examination, impact, competence, patient safety, curriculum

Conhecimento de enfermeiros sobre evento adverso na atenção primária à saúde

Objetivo: analisar o conhecimento dos enfermeiros sobre segurança do paciente e eventos adversos na atenção primária. Método: estudo descritivo, exploratório de abordagem qualitativa realizado com enfermeiros da Estratégia de Saúde da Família, na regional de saúde leste de Teresina-PI. A técnica de coleta de dados foi a entrevista semiestruturada realizadas no período de dezembro de 2017 a junho de 2018. Os dados foram submetidos à Análise de Conteúdo Temática. A pesquisa foi autorizada pelo Comitê de Ética em Pesquisa da Universidade Federal do Piauí sob o número de parecer 2.216.546. Resultados: a partir da análise de conteúdo emergiram duas categorias: Conhecimento das enfermeiras sobre segurança do paciente e eventos adversos; Eventos adversos e estratégias para minimizar seus efeitos na atenção primária. Considerações Finais: identificou-se que os profissionais, em parte, confundem evento adverso com reação adversa relacionada a medicamentos ou vacina, por exemplo. E o conceito de segurança do paciente foi ampliado, dentro da abordagem da Atenção Primária à Saúde. Observou-se uma necessidade de medidas mais efetivas em torno da temática como trabalhar a comunicação interprofissional; melhorar a gestão dos recursos; motivá-los a compartilhar dúvidas e acontecimentos como forma de aprendizagem.

Attitudes of doctors and nurses to patient safety and errors in medical practice in the Gaza-Strip: a cross-sectional study

ObjectivesThis study examined the attitudes of nurses and doctors to key patient safety concepts, evaluated differences and similarities between professional groups and assessed positive and negative attitudes to identify target...

Technological innovation in the design process of an acoustic panel to the hospital environment

Acoustic pollution has become a global problem, but, having negative effects on the health and well-being of people, it becomes a variable to control in hospital environments. That is why this article presents the design of a panel with noise reduction properties and with characteristics that allow to replace the restrictions of the hospital environment, through the concepts of Home Warmth and Patient Safety as fundamental bases to limit the problem. The design exercise uses the VDI 2221 model and the problem / solution symmetry model in order to restrict the design and refine it without losing sight of the context for which the panel is designed. As a result, a design of the structure is obtained that later goes on to a stage of improvement of details, in which characteristics associated to the materials, production processes and other additional characteristics are defined.

Significant event reporting in veterinary practice

Patient safety has been defined as ‘the reduction of risk or unnecessary harm associated with healthcare to an acceptable minimum’.1 As veterinary professionals, the safety of our patients has always...

Awareness and Level of Knowledge About Surgical Site Infections and Risks of Wound Infection Among Medical Physicians in King Abdulaziz University Hospital: Cross-Sectional Study.

BackgroundSurgical site infections (SSIs) are one of the leading causes of death, and its prevention is a key element of applying the concept of patient safety and quality care.ObjectiveThis study aimed to assess the level of knowledge about SSIs and risks of wound infection among medical physicians in King Abdulaziz University Hospital.MethodsAll surgical and medical consultants, specialists, residents, and medical interns were invited to participate in the study. A 20-Item multiple-choice questionnaire was developed by reviewing the previous literature and with the help of a group of certified surgeons to assess the level of knowledge in all participants.ResultsA total of 119 doctors were included in this study. Among all respondents, 92 (77.3%) were intern doctors, 16 (13.4%) were resident doctors, and 11 (9.2%) were specialist doctors. Moreover, 66 (55.5%) doctors knew the definition of SSI. Only one-quarter, that is, 30 (25.2%) doctors knew about the incidence of SSI. In addition, 8 doctors (6.7%) had good knowledge, 75 (63.0%) had fair knowledge, and 36 (30.2%) had poor knowledge regarding SSI according to this study.ConclusionsLevel of knowledge about SSIs and risks of wound infections among medical physicians should be improved to ensure better wound care and quality care for the patients.

Teaching Patient Safety Concepts Using Gaming and Simulation

Mckay, Mary DNP, FNP, CNE; Sanko, Jill PhD, ARNP-BC, CHSE-A, FSSH; Salani, Deborah DNP, PMHNP-BS, ARNP Author Information

Patient Safety Education for Medical Students: Global Trends and Korea’s Status

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors’ roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.

Defining Patient Safety: a Student Perspective.

Patient safety is recognised as an important aspect of the undergraduate medical curriculum. However, packed medical curricula have been slow to evolve despite repeated mandates and large-scale tragedies resulting from unlearnt lessons. The aim of this work was to explore students' perspectives on patient safety to inform curriculum re-design. Using a qualitative approach, medical students from year 2 and year 4 of the undergraduate course were invited to participate in focus groups to consider: their personal conceptualisation of patient safety, their perceptions of patient safety education in the existing curriculum and their collective preferences for future teaching in this area. Transcripts of the focus groups were subjected to thematic analysis. Six focus groups were convened with a total of 77 students. Thirteen major themes were identified which included conceptual ambiguity, healthcare culture, error theory, specific safety topics (such as infection prevention and control, medication safety, technical/procedural safety, communication and other non-technical skills), self-awareness, patient-centredness, low student morale and raising concerns. Students were more aware of technical than non-technical competence. They wanted learning aligned to the realities of practice, a clearer concept of patient safety and improved visibility of patient safety topics within an integrated curriculum. Students are keen to engage with safety topics but frequently feel disempowered as future change agents. Educators need to advocate a clear definition of patient safety and consider the implication of the theory-practice gap on students' evolving attitudes.

Does teamwork and communication improve with simulation training? An evaluation of simulation training videos in Bihar, India

BACKGROUND
 High rates of medical error – attributed to ineffective communication among health care providers – poses a threat to patient safety. We embedded Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS™) concepts within a simulation-based curriculum and trained clinical teams providing intrapartum care in low-income settings. We evaluated whether simulation can be used to improve teamwork and communication among clinical teams.
 METHODS
 Nurse mentors facilitated and video-recorded simulated clinical scenarios to give health care providers (mentees) the opportunity to practice both technical and non-technical skills. Independent evaluators reviewed video-recorded simulation scenarios at midpoint and endpoint to evaluate changes in use of evidence-based practices. Semi-structured interviews were also conducted with nurse mentors to explore their experiences teaching non-technical skills to clinical teams.
 RESULTS
 Five hundred and sixty-six simulated clinical scenarios were included in the final analysis. Adoption of techniques to improve communication and teamwork, such as the ‘SBAR’ technique and ‘think out loud’, increased from midpoint to endpoint in all simulated scenarios.
 CONCLUSION
 Incorporation of TeamSTEPPS™ concepts into a simulation training program for health care providers improved teamwork and communication in simulated scenarios and can potentially be extended to actual emergency cases.

Attitudes of dental undergraduate students towards patient safety in a UK dental school.

Patient safety is an important issue in health care. In the United Kingdom, wrong site tooth extraction contributes to a significant proportion of adverse or harmful events, coined "never events." Therefore, patient safety within the field of dentistry is of paramount importance. This novel study aims to explore the teaching of patient safety to undergraduate dental students and their current attitudes to the subject. Focus groups were held at Barts' and The London School of Medicine and Dentistry, QMUL in 2018 to ascertain the views and opinions of thirteen third-year dental undergraduate students. Thematic analysis was performed on verbatim transcripts. Key themes were highlighted. All students could provide a complete definition of patient safety and of "never events," with examples. There was a strong emphasis upon awareness of one's own competence and the need for effective communication to maintain patient safety. Small group teaching and the requirement for standardization of teaching were encouraged. The challenge of incorporation of the patient safety concept into the clinical routine without causing repetition during teaching was highlighted. The results show a positive attitude towards the concept and the teaching of patient safety. All students understood patient safety concepts and techniques used to prevent adverse or harmful events. This study proves that teaching on the subject was thought to be of value. It is crucial that the teaching of patient safety is introduced and built upon within the early years of dental undergraduate training so that its practice becomes second nature.

Perspectives on Patient Safety Education in the Kenyan Preregistration Nursing Curriculum

Patient safety education is recognised as a key ingredient in the development of safety competencies in healthcare professionals. To ensure that patient safety is emphasised in the preregistration education, it is important that it be integrated explicitly in the curriculum. This study aimed at identifying explicit patient safety concepts in the Kenyan nursing curriculum and exploring the perspectives of the nursing faculty members and clinical nurses on the integration of patient safety in the curriculum. A qualitative content analysis was conducted on the relevant curriculum documents from two universities. In-depth, semi-structured interviews were conducted on a purposive sample of 13 staff members of the nursing faculty from the university and 14 clinical nurses from the hospitals where the students undergo clinical instruction. A thematic analysis was carried out on the transcribed interviews from which four themes and subthemes emerged. The curriculum content analysis did not identify any explicit patient safety content but the content was rather implicit within the curriculum as a series of statements and inferences to patient safety. The themes included curriculum issues, student characteristics, a patient safety culture, clinical education issues, and the academic-clinical relationship. To ensure training of a nurse who is competent in patient safety, the concepts must be integrated in the curriculum, the academic and clinical faculties need to be well equipped to teach and assess these concepts, the patient safety culture in clinical placement sites should be conducive to allow for learning about patient safety, and better collaboration between the academic and clinical settings for integration of patient safety in nursing education should be realised.

98 - Teaching Patient Safety Concepts to Pediatric Trainees

98 - Teaching Patient Safety Concepts to Pediatric Trainees

Can the craze for patient safety hinder a more holistic care of the person in the health care system?

Background and objective: Since the publication of a report by the Institute of Medicine on the mortality associated with adverse events in the hospital, patient safety has become one of the essential objectives of the health care system. However, this movement tends to obscure the fundamental link between safety and quality of care in the health system. The study was aimed to demonstrate that the only focus on patient safety concept overshadow the more holistic care of the person and the population in the health care system.Methods: Documentary research in the Pubmed database and the Google Scholar search engine, from 1999 to 2017.Results and conclusion: Highly targeted safety research without addressing quality at first can only be a long-term panacea for current health policies. For cause, a one-way look at patient safety could lead to significant impacts at the population level. In order to get out of this craze, health system decision-makers would benefit from supporting clinical governance advocating humanistic and holistic strategies for interventions, engaging in a process of continuous improvement of the Quality of care more profitable in the long term. In order to overcome this craze, health system decision-makers would benefit from supporting clinical governance that advocates humanistic and holistic strategies for interventions, by engaging in a process of continuous improvement in the quality of care that is most beneficial in the long term. This posture is similar to Caring's well-known nursing model.

Children’s Hospital Quality and Safety Rounds

Purpose: Safety rounds provide a venue for discussing safety concerns, identifying and facilitating solutions for safety issues, and educating staff about patient safety concepts. They also allow the team to obtain and act on information that identifies areas for improvement. This increases awareness of safety issues among all healthcare staff. Further, there is opportunity to work with families to engage them in advocacy and safety. In May 2013, a multidisciplinary pediatric patient safety team was developed at UF Health Shands Children’s Hospital (SCH) …

Oral Surgery Patient Safety Concepts in Anesthesia.

An effective office emergency preparedness plan for the oral and maxillofacial surgery office can be developed through the use of well-designed checklists, cognitive aids, and regularly scheduled in situ simulations with debriefings. In order to achieve this goal, the hierarchal culture of medicine and dentistry must be overcome, and an inclusive team concept embraced by all members of the staff. Technologic advancements in office automation now make it possible to create interactive cognitive aids. These enhance office emergency training and provide a means for more rapid retrieval of essential information and guidance during both simulations and a real crisis.

Primer in Patient Safety Concepts: Simulation Case-Based Training for Pediatric Residents and Fellows.

Health care quality and patient safety remain one of the core areas of focus for the Accreditation Council for Graduate Medical Education. In addition to using the traditional approach to teaching patient safety, disclosure of a safety event and introduction to the concepts of just culture and safely doing less add a unique perspective to our module. This 4-hour learning activity was conducted using a formal PowerPoint presentation, simulation, and interactive discussion/debriefing. The presentation reviewed safety concepts and introduced learners to the concepts of just culture and safely doing less. The first case was a standard scenario in which participants assessed a sick but stable child and evaluated the use of premature closure bias that might preclude them from making the correct diagnosis. The second case represented disclosure of a medical error. Participants were evaluated on their communication/professionalism skills and challenged to discover overuse as one of the root causes of medication error. Pre- and posttest surveys were used for learner evaluation. Participants showed significant improvement on content-based questions, increasing from 51.7% to 69.3% correct (p < .001). After Bonferroni correction, only the question on overdiagnosis showed significant improvement (p = .001). Participants reported significantly increased confidence in all areas evaluated (p < .001). Participants placed high value on the workshop. The question on overdiagnosis showed significant improvement on the posttest. The concepts of patient safety, just culture, and safely doing less can be introduced to learners at a formative stage in their career through simulation.

Sustained Impact of a Pediatric Resident-Led Patient Safety Council.

The aim of the study was to evaluate the impact of a resident-led patient safety council. This study measured change in resident perceptions and knowledge of safety issues for 3 years, as well as behavioral choices to participate in patient safety activities during and after residency. Pediatric residents formed a resident-led safety council to engage their peers in patient safety activities. Surveys were distributed annually from 2013 to 2015 to measure residents' perception and knowledge surrounding patient safety. The number of patient safety reports submitted by residents was tracked for the same period. In addition, recent graduates were surveyed to assess the influence of the council on postresidency involvement in patient safety. Resident perception of the institutional culture of safety improved and knowledge of basic patient safety concepts increased. The number of resident-submitted safety reports increased from 6.2 to 15.2 reports per month in the 2013 and 2015 academic years, respectively. Surveys of recent graduates suggest that involvement with the safety council during residency fostered future engagement in patient safety. This resident-led council models successful involvement of trainees in system-based patient safety. Such involvement can help shape the safety culture within a training program and encourages continued participation in patient safety after residency completion.