Patient Safety Development Research Articles

Advancing Patient Safety Culture: A Systematic Review of Strategies and Best Practices in Riyadh, Saudi Arabia

This research study is an important contribution to that critical argument of how to develop patient safety culture in health care settings in Riyadh, Saudi Arabia. Having understood the pivotal role played by culture in the improvement of patient outcomes, very systematically lays down a literature review looking for the prevalent gaps and inefficiencies occurring in the present practices. That is to mean, the paper duly critically appraises different approaches and interventions that have greatly contributed to making a huge difference in the organizational climate, regarding the culture of safety through a systematic and rigorous manner. These findings, therefore, underline the need for full-fledged deployment of safety protocols, fostering a transparent atmosphere through which healthcare providers should learn from their mistakes, and demand quality enhancement programs. Presents a summary of such findings, and their general meanings with regards to health policy, leadership, and practice that suggest a way for healthcare institutions in Riyadh, to draw a more resilient and patient-centered safety culture. This research contributes to the academic void of discourse of patient safety by offering practical insights to the health leaders and policy-makers in Riyadh that, when implemented, will optimize the quality of care in health care and experience that patients have in it

Results of a qualitative semi-structured interview study with hospital nursing staff to improve incident reporting systems in Estonia

ObjectiveNurses and their leaders are known for actively using incident reporting systems. However, information sharing about lessons learned from incidents has rarely been reported in previous studies. This study aimed to describe nurses’ and nursing managers’ experiences with incident reporting system information sharing and their perceptions of patient safety development needs. Material and methodsSemi-structured individual and group interviews were conducted with nursing staff in Estonia (n=26). Collected data was analyzed using the inductive content analysis method. The COREQ checklist was used for study report. ResultsNursing staff considered information sharing of lessons learned crucial. First, it was necessary to raise patient safety awareness among employees. Second, the importance of learning from mistakes to protect themselves from legal consequences and improve public trust was highlighted. Nursing staff had traditional ways of sharing information about lessons learned. However, because of the lack of organized strategies, nurses resorted to private discussions or self-initiated investigations. Nursing staff reported a need to develop patient safety by supporting nurses’ patient safety competencies and training, and to establish the use of a reporting system in daily care. The precondition was a positive patient safety culture, which would be improved by open communication among nursing staff and sufficient resources. ConclusionsInformation sharing from safety incident reports should rely on organized strategies to avoid self-initiated practices and misinformation. Awareness of the complexity of implementing patient safety initiatives and adequate responsiveness from hospital executives can help establish practices supporting staff to feel secure when discussing safety issues.

Evaluating the Impact of Hospital Accreditation on Patient Safety Culture in Saudi Arabia Healthcare Facilities.

The impact of hospital accreditation on the organizational safety culture among healthcare workers, an essential indicator of patient safety, has yet to be directly quantified in Saudi Arabia's healthcare system. This study aims to investigate this impact to sustain and maintain a positive safety culture in Saudi Arabia's healthcare institutions. A cross-sectional assessment was conducted in five public hospitals in Makkah. Three hundred forty healthcare workers participated using a self-administered questionnaire. Data were analyzed using descriptive statistics, ANOVA, one-sample t-test, and multiple regression for a comprehensive understanding. Regression analysis revealed significant gender differences in patient safety ratings (B = 0.480, p < 0.001). Age positively influenced scores, with higher ages resulting in higher scores (B = 0.127, p = 0.041). The ratings were also associated with respondents' nationality (B = 0.169, p < 0.001) and education levels (B = -0.186, p < 0.001). Respondents rated disasters and training as the highest in patient safety culture, followed by facility safety and security, hazards and hazardous materials safety, utility and building safety, fire safety, and quality improvement. At the same time, leadership, commitment, and support received the lowest score. This study illustrates a strong connection between accreditation and improved patient safety, emphasizing the importance of quality improvement and leadership commitment. These insights can guide policymakers and healthcare executives in Saudi Arabia and similar countries toward developing a robust patient safety culture. It stresses the importance of considering human factors and organizational culture when developing patient safety models.

Effectiveness of Educational Interventions to Develop Patient Safety Competencies in Undergraduate Nursing Students: A Systematic Review.

Nursing professionals are key to providing safe care that improves patient outcomes. Hence, it is essential to focus on developing nurses' patient safety competencies and principles. This review examined the effectiveness of educational interventions in developing patient safety knowledge, skills, behaviors, and attitudes in undergraduate nursing students. The search strategy aimed to identify published and unpublished studies in databases and grey literature. Studies were assessed using the Joanna Briggs Institute critical appraisal tools. A total of 36 studies met the inclusion criteria. The teaching methods employed single or combined interventions and the educational interventions suggested either improvements in outcomes or no impact. The effectiveness of educational interventions to develop patient safety competencies in undergraduate nursing students, either as a single or combined strategy, was mixed. Further research is needed to provide more robust evidence on which teaching method for patient safety is most effective.

Development and Evaluation of Patient Safety Interventions: Perspectives of Operational Safety Leaders and Patient Safety Organizations.

The purpose of this study is to understand how patient safety professionals from healthcare facilities and patient safety organizations develop patient safety interventions and the resources used to support intervention development. Semistructured interviews were conducted with patient safety professionals at nine healthcare facilities and nine patient safety organizations. Interview data were qualitatively analyzed, and findings were organized by the following: patient safety solutions and interventions, use of external databases, and evaluation of patient safety solutions. Development of patient safety interventions across healthcare facilities and patient safety organizations was similar and included literature searches, internal brainstorming, and interviews. Nearly all patient safety professionals at healthcare facilities reported contacting colleagues at other healthcare facilities to learn about similar safety issues and potential interventions. Additionally, less than half of patient safety professionals at healthcare facilities and patient safety organizations interviewed report data to publicly available patient safety databases. Finally, most patient safety professionals at healthcare facilities and patient safety organizations stated that they evaluate the effectiveness of patient safety interventions; however, they mentioned methods that may be less rigorous including audits, self-reporting, and subjective judgment. Patient safety professionals often utilize similar methods and resources to develop and evaluate patient safety interventions; however, many of these efforts are not coordinated across healthcare organizations and could benefit from working collectively in a systematic fashion. Additionally, healthcare facilities and patient safety organizations face similar challenges and there are several opportunities for optimization on a national level that may improve patient safety.

Developing patient safety scale for hospitals.

The study aimed to contribute to the literature with a reliable and valid scale for hospitals to be used in determining the current patient safety culture and following up on its development. The study was conducted with the participation of 1137 healthcare professionals selected using the convenience sampling method in 3 secondary-care state hospitals and three research and training hospitals, one of which was affiliated with a medical faculty, and two were affiliated with the Health Sciences University. To begin with, to discover the latent structure of the items on the scale, an Exploratory Factor Analysis (EFA) was performed. Additionally, to determine the factor structure of the scale, the Confirmatory Factor Analysis (CFA) method was used. The Cronbach's alpha coefficient was calculated to check the reliability of the responses. According to Kaiser-Meyer-Olkin (KMO = 0.924) coefficient and the result of Bartlett's test of sphericity (χ 2 = 9748.777, df = 770), it was determined that the data structure was suitable for factor analysis. The Cronbach's alpha coefficient of the total scale was found to be 0.921. According to the EFA results, the scale was determined to have seven subscales, which were 1. Organizational Learning, Development, and Communication, 2. Management Support and Leadership, 3. Reporting Patient Safety Events, 4. Number of Personnel and Working Hours, 5. Response to Error, 6. Teamwork, and 7. Working Environment. The goodness-of-fit index results of the scale showed a good model fit (χ 2 / df = 3.04, RMSEA = 0.06, CFI = 0.97, NFI = 0.95, IFI = 0.97, SRMR = 0.06). The Cronbach's alpha coefficients of the subscales varied between 0.66 and 0.91. The results showed that the Patient Safety Scale for Hospitals is a valid and reliable measurement instrument for healthcare professionals.

Perceptions and Practices of Saudi Hospital Pharmacists Towards Reporting Medication Errors Including Near Misses.

Medication errors (MEs) represent a patient safety concern that can have negative consequences on patients in the short and long term. Community pharmacists play an important role in the medication management process, which urges the need for their role in managing MEs. Therefore, this study aimed to investigate the perceptions and attitudes of Saudi pharmacists towards reporting MEs. A cross-sectional study was conducted using a semi-structured questionnaire that was distributed to Saudi pharmacists. The questionnaire was distributed to pharmacists via email after they had provided their consent to take part in the study. Data from the questionnaire were analysed using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Armonk, NY), where descriptive statistics were applied. The findings showed that most pharmacists appreciated the importance of reporting MEs and the role the reporting played in improving the quality of healthcare delivery. However, pharmacists raised many concerns regarding barriers to reporting. Such barriers to reporting included blaming patients or healthcare professionals, underdeveloped protocols, and the lack of standard procedures for ME reporting. Moreover, inadequate communication between healthcare professionals (for example, between pharmacists and doctors) represented an additional barrier to reporting MEs. MEs and near misses are underreported among Saudi pharmacists due to many operational and communication challenges. These findings are useful for healthcare authorities involved in developing patient safety frameworks for reporting MEs and near misses. Future work can also determine the attitudes of other healthcare professionals involved in the medication management process.

Longer work experience and age associated with safety attitudes in operating room nurses: an online cross-sectional study

BackgroundPatient safety is fundamental when providing care in the operating room. Still, adverse events and errors are a challenge for patient safety worldwide. To avoid preventable patient harm, organisations need...

국내 의료기관의 환자안전사고 관련 요인 분석: 2019-2022년 환자안전보고 데이터 활용 이차분석 연구

Objective : The purpose of this study is to establish strategies to prevent patient safety accidents by identifying factors related to patient safety accidents in domestic medical institutions, and to use them as basic data for developing patient safety prevention programs. Methods : This study is a secondary data analysis study using the raw data of the "2019-2022 Patient Safety Report Data" published by the Medical Institution Evaluation and Certification Institute of the Ministry of Health and Welfare. Data analysis was performed using the SPSS 23.0 program. Results : Depending on the degree of risk, risk events, proximity errors, and red signal events appeared in order, and in terms of gender, women had a relatively higher percentage of red signal events and red signal events for proximity errors than men. Factors affecting the degree of risk of patient safety accidents are gender, age, accident time, reporter, medical institution classification, bed size, accident location, and type of accident. Conclusion : Medical institutions in Korea need to develop standardized patient safety guidelines to prevent patient safety accidents according to bed size and age, and to strengthen patient safety education and patient safety capabilities. In addition, the elderly mainly report patient safety accidents due to falls, so nursing education and facilities are needed to reduce falls.

Accreditation Surveyor and Patient Safety: Learning from World Patient Safety Day 2023 (Literature Review)

This article serves as a commemoration for World Patient Safety Day (WPSD) 2023, observed every 17th of September. Unlike previous years, this year’s theme is "Engaging Patients for Patient Safety" with the slogan "Elevate the voice of patients!". All parties are encouraged to actively participate and collaborate in involving patients and their families in their care. This involvement encompasses primary and secondary care facilities, whether in-patient or outpatient settings, community health clinics or hospitals. The role of surveyors has been further enhanced to evaluate and proactively ensure the participation of patients and their families in their care. Numerous studies have shown that the roles of surveyors, be it in guidance or accreditation, are crucial in ensuring this engagement occurs and that improvements in patient safety and quality are achieved. Accreditation surveyors play a vital role in supporting and developing patient safety practices that actively involve patients. They assist health facilities in understanding and adhering to required patient safety standards while facilitating collaboration between patients, families, and care teams. The role of surveyors in ensuring patient safety becomes increasingly relevant and essential in the pursuit of safer and higher-quality healthcare services.

Zdravstvena njega i njezin utjecaj na kulturu sigurnosti

Introduction: The World Health Organization defines patient safety as “a framework of organised activities that creates cultures, processes, procedures, behaviours, technologies, and environments in health care”. Patients have a right to expect that every effort is made to ensure their safety as users of all health services. The healthcare system today is facing major challenges, including a lack of human resources, an excessive workload of healthcare professionals, a large number of complex cases, the use of new technologies, and many others. Patient safety is an important component of health care, and it depends on several factors, such as the safety culture, organisation policy, competencies of personnel, and the way care is provided. Safety culture recognises high-risk activities; it is defined as a no-blame culture, and it seeks solutions to problems through an interdisciplinary approach. Objective: To investigate patient safety culture from the perspective of nurses/nursing technicians and the association between nursing care and patient safety in health institutions through a systematic literature review.Methods: A descriptive method was used, a review of scientific and professional literature in the field of nursing care, patient safety culture, patient safety, and adverse events.Results: Results show that patient safety culture characteristics are correlated with nurses’/nursing technicians' intention to report errors. A stronger safety culture along with a developed patient safety competency was found to be significantly associated with a lower incidence of adverse events and surgical site infections, indicating that nurses' competence could reduce the occurrence of adverse events and improve patient safety culture.Conclusion: Improved patient outcomes are associated with a safety culture characterised by shared attitudes among healthcare providers about the importance of patient safety, loyalty, communication transparency, and shared trust in the efficacy of safety measures.

Finnish emergency medical services managers’ and medical directors’ perceptions of collaborating with patients concerning patient safety issues: a qualitative study

ObjectivesThis study aimed to describe emergency medical services (EMS) managers’ and medical directors’ perceptions of collaborating with patients concerning patient safety issues in the EMS.DesignThe study used a descriptive qualitative...

Using PSI-90 Scores to Improve Patient Safety and Quality Ratings

The Agency for Healthcare Research and Quality (AHRQ) developed patient safety indicators (PSIs) to help hospitals identify potentially preventable complications after surgeries and procedures.1 Despite their use by federal programs to assess quality of care, there is no consensus on their accuracy as a marker of quality.2 This article examines how a midsize community hospital used PSI-90 scores to develop targeted interventions that resulted in improved patient safety and quality ratings.

Aligning work-as-imagined and work-as-done using FRAM on a hospital ward: a roadmap

IntroductionModern safety approaches in healthcare differentiate between daily practice (work-as-done) and the written rules and guidelines (work-as-imagined) as a means to further develop patient safety. Research in this area has...

ASSESSING CRITICAL CARE NURSES’ KNOWLEDGE ON OXYGEN THERAPY IN COVID-19 PATIENT CARE IN TURKIYE; A MULTICENTER STUDY

Objective: Oxygen therapy for individuals with COVID-19 includes best practices for supportive management of acute respiratory syndrome. The aim of this study was to determine critical care nurses’ levels of knowledge on oxygen therapy during the COVID-19. Method: This was a descriptive study. The study was conducted with COVID-19 critical care nurses (N=446) in a total of 16 hospitals affiliated with a healthcare group in Turkey. A total of 322 nurses were included in the study. The data were collected via the Oxygen Therapy Information Form prepared based on the literature through Google survey. Results: According to the oxygen therapy subscales, the mean score of the nurses varied from 40.77 to 86.21, and their total mean score was 72.99 (fairly). The nurses’ knowledge on oxygen therapy was strongly correlated with their educational level and manner of work (p&lt;0.05). Conclusions: It can be asserted that in oxygen therapy, their knowledge on nursing interventions was adequate; however, their knowledge on oxygen therapy definitions and concepts was inadequate. In order to develop patient safety concerning oxygen therapy in COVID-19 patients, it is recommended that training programs be planned and competencies of nurses be assessed. In order to qualify legal competence about the safe oxygen therapy, clear protocols and professional guidelines are recommended.

Effectiveness of educational interventions to develop patient safety knowledge, skills, behaviours and attitudes in undergraduate nursing students: a systematic review protocol

IntroductionPatient safety is a healthcare discipline that aims to prevent and reduce patient harm, risks and errors during the provision of healthcare. Given the size of the nursing workforce in...

A Quality Improvement Initiative to Improve Patient Safety Event Reporting by Residents.

Residents play a key role in patient care at academic medical centers and have unique insights into safety improvement opportunities. At our institution, <1% of safety events were reported by resident trainees. The primary objective of this quality improvement (QI) initiative was to increase the monthly incidence of event reporting by pediatric residents by 20% from baseline within 12 months. A QI team used the model for improvement to identify barriers to submitting safety event reports. The team used multiple intervention cycles to increase knowledge and promote engagement in event reporting. Interventions included educational tip sheets, a hospital-wide Morbidity and Mortality (M&M) conference, peer recognition and acknowledgment by senior leadership for report submission, and an interactive reporting activity. The outcome measure was monthly number of reports filed by residents. The process measure was the number of unique residents submitting a report each month. Time to complete a report was a balancing measure. The number of reports placed by residents increased significantly, with a centerline shift from 15 to 29 reports per month (statistical process control chart-Fig. 3). The number of unique residents submitting reports increased from 10 to 22 per month. The time to complete a report was unchanged. Engaging residents in patient safety initiatives through education, experiential learning, and recognition can increase safety event reporting by residents. Future planned interventions include enhancing safety event reporting technology, developing patient safety faculty and resident champions, and increasing transparency regarding outcomes of safety event reports.

Developing patient safety standards for health-care quality promotion in neonatal intensive care units: A mixed-methods Protocol.

Neonatal intensive care unit (NICU) is one of the accident-prone settings in the health-care system. There is a series of structural and process threats to the safety of infants hospitalized in this unit, which can be prevented by taking the right actions. For this purpose, developing standards based on current knowledge, available resources, and the context that provides care can determine patient injury prevention requirements. Likewise, it can be a source for national development and application of related guidelines and protocols. This study aims to develop patient safety standards in the NICUs of Iran. This mixed-methods study will apply the exploration, preparation, implementation, and sustainment framework to develop patient safety standards. In each phase of this framework, a set of activities take place. Exploration is based on the world health organization model to develop standards. Determining the validity and applicability of standards will be done in Phase 2 (Preparation) and Phase 3 (Implementation), respectively. Since the long-term effects are not desired, the fourth phase (Sustainment) will not be considered. Patient safety standards from this study will contribute to efficient and effective, equitable, and high-quality health-care delivery. The application of them will further promote patient safety and the quality of medical care in Iranian NICUs.

Patient safety educational interventions: A systematic review with recommendations for nurse educators.

AimThis study identified and evaluated tested patient safety educational interventions. This study also described the content, curricular structures and teaching strategies of the educational interventions and determined the methods used for evaluating patient safety learning outcomes.DesignThe Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines directed this review.MethodsSearches for articles describing and evaluating patient safety educational interventions were conducted using four scholarly databases. Study quality was assessed using the McMaster Critical Review Form.ResultsSeven studies met the inclusion criteria. Educational interventions were either presented as stand‐alone courses or as lessons embedded in an existing course. All studies employed a mixture of various teaching modalities and several evaluation methods and outcomes. Mixed results were observed in terms of the effects of educational interventions. Future researchers should continue to develop patient safety curricula and examine their effect on student competencies with stronger methodological rigour.

Commentary: Student outcomes of an international learning collaborative to develop patient safety and quality competencies in nursing.

Commentary: Student outcomes of an international learning collaborative to develop patient safety and quality competencies in nursing.