Factors Affecting Patient Safety Research Articles

Determinants of clinical nurses’ patient safety competence: a systematic review protocol

IntroductionPatient safety has become a fundamental element of healthcare quality. However, despite the ongoing efforts of various organisations, patient safety issues remain a problem in the healthcare system. Given the...

Identifying the risk factors of patient safety in internet hospitals: A mixed methods study

ObjectiveThe purpose of this study was to identify key risk factors and their interrelationships for patient safety in internet hospitals from a system perspective, using mixed methods of qualitative and quantitative analysis. MethodsThis study constructed a comprehensive indicator system of patient safety risk factors in internet hospitals by qualitative analysis using the Patient Safety Systems (SEIPS) model as a framework. Risk factors were initially identified through a literature review and subsequently refined using a Delphi survey involving 24 experts related to internet hospitals in China. The identified indicators were quantitatively analyzed to determine key risk factors and their influencing mechanism using the Decision Making Trial and Evaluation Laboratory (DEMATEL) and Interpretive Structural Modeling (ISM) methods. ResultsThe qualitative analysis established a patient safety risk factor indicator system for internet hospitals, comprising 23 elements across six dimensions. Quantitative analysis employing the DEMATEL-ISM approach revealed that risk management has the highest centrality. Among cause factors, task complexity exerts the most significant impact on other factors, while network information security exhibits the highest absolute value among result factors. Risk factors are categorized into three levels: surface, deep, and root factors, with task complexity, legal and regulatory, and guidance policy being the root factors at the foundation of the system. ConclusionsOur study offered a systemic perspective on analyzing risk factors for patient safety in internet hospitals. Policymakers and managers of internet hospitals should take advantage of the interrelationships among these factors to mitigate patient safety risks by effectively controlling key factors. Public Interest SummaryIn the rapidly evolving landscape of internet hospitals, ensuring patient safety is paramount. This study aimed to comprehensively identify and understand key risk factors influencing patient safety within these digital healthcare platforms. Using mixed methods of qualitative and quantitative analysis, the study examined the intricate interplay of factors affecting patient safety. Our methodology involved constructing a risk factors indicator system based on the Patient Safety Systems (SEIPS) model. By employing the integrated Decision-Making Trial and Evaluation Laboratory along with the Interpretive Structural Modeling method, we unveiled the core risk factors and their intricate relationships. Recognizing the interconnectivity of these factors allows us to develop effective risk mitigation strategies that enhance patient safety in internet hospitals. This study encourages stakeholders to leverage the dynamic relationships among these factors to ensure safer online healthcare experiences for patients.

Factors Affecting Patient Safety By Nurses In Medan

Factors Affecting Patient Safety By Nurses In Medan

Barriers and enablers of medication safety: A qualitative study from public hospitals in Kaduna State, Nigeria

Background: There has been a growing concern for patient safety in recent years. Little is known about medication safety in Nigeria. Anecdotal evidence has indicated widespread medication errors and insufficient error reporting in healthcare facilities. Aim: This study aimed to explore the factors affecting medication safety in selected public health facilities in Kaduna State, Nigeria. Methods: Semi-structured interviews (using a topic guide) were conducted with fifteen (15) purposively sampled healthcare providers (doctors, nurses, and pharmacists) in two hospitals in Kaduna State, Nigeria. The data were both inductively and deductively analysed using content analysis. Results: Themes relating to factors affecting medication safety were mapped onto the Vincent multi-level framework. Interview data revealed 30 subthemes as factors affecting patient safety, and respondents also suggested improvements in several areas, including attitudes, training, and education. Conclusion: Factors affecting medication safety were identified, as was the need for prioritising patient safety by regulatory agencies and practitioners.

Assessment of patient safety culture and associated factors among healthcare professionals in public hospitals of Bahir Dar City, Northwest Ethiopia: A mixed-methods study.

Patient safety is an essential component of healthcare quality. Despite enormous advances in medical knowledge, many adverse events continue to endanger patient safety. Although mixed-method studies are necessary to gain a deeper understanding of safety culture, few studies provide practical evidence of patient safety culture and associated factors in Ethiopia. This study aimed to assess patient safety culture and associated factors among healthcare professionals in public hospitals in Bahir Dar City, Northwest Ethiopia. A cross-sectional study design was employed, in triangulation with qualitative methodologies, from March 10 to April 10, 2022. A stratified sampling technique was used to select 420 study participants from three public hospitals. A standardized tool measuring 12 patient safety culture composites was used for data collection. Purposive sampling was employed in the qualitative study. Bi-variable and multivariable linear regression analyses were performed using SPSS version 23, with significance set at a 95% confidence interval and a p-value of <0.05. Content analysis was utilized in the qualitative study. The overall patient safety culture score was 47.6% (95% CI: 42.7, 52.5). Age (β = 1.196, 95% CI: (0.968, 1.322), patient safety training (β = 0.168, 95% CI: 0.040, 0.297), working in pediatric wards (β = 0.236, 95% CI: 0.099, 0.370), and resource availability (β = 0.346, 95% CI: 0.220, 0.473) were significantly associated with patient safety culture. The in-depth interviews identified infrastructure, communication barriers, lack of management support, poor governance, healthcare professionals' knowledge, skills, and attitudes, and patient involvement during treatment as factors affecting patient safety. This study concludes that the patient safety culture in the studied hospitals is suboptimal, falling below the acceptable threshold. Enhancing resource availability, providing continuous patient safety training, improving communication systems, and fostering a supportive management environment are essential steps towards building a safer healthcare system.

The Influence of Attitude toward Job Rotation, Professional Self-concept and Organizational Commitment on Patient Safety Nursing Activities: A Cross-Sectional Study

Purpose: This study aimed to examine the influence of attitude toward job rotation, professional self-concept and organizational commitment on patient safety nursing activities.Methods: In this descriptive correlational study, the participants were 120 nurses with over 1 year of experience working at a tertiary general hospital in Seoul. Data were analyzed using descriptive statistics, the independent t-test and one-way analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical multiple regression analysis.Results: The average scores for attitude toward job rotation, professional self-concept, organizational commitment and patient safety nursing activities were 3.07±0.43, 5.80±0.87, 3.11±0.55, and 4.57±0.35, respectively. Patient safety nursing activities showed statistically significant differences according to age (F=4.66, p=.011), marital status (t=-2.06, p=.042), and total clinical experience (t=-2.38, p=.019). Attitude toward job rotation (r=.23, p=.011), professional self-concept (r=.36, p&lt;.001), and organizational commitment (r=.30, p&lt;.001) were positively correlated with patient safety nursing activities. The Factors affecting patient safety nursing activities were total clinical experience (β=.24, p=.029) and professional self-concept (β=.22, p=.037), with a total explanatory power of approximately 20%.Conclusion: These results suggest that nurses’ activities need to be planned based on their total clinical experience. and professional self-concept predicted higher patient safety nursing activities among nurses.

Effect of Nurses’ Professionalism, Work Environment, and Communication with Health Professionals on Patient Safety Culture (AHRQ 2.0.): A Cross-Sectional Multicenter Study

Aims. To identify nurses’ professionalism, work environment, and communication with healthcare professionals as factors influencing clinical nurses’ perception of patient safety culture. Background. Patient safety is a representative indicator of the quality of nursing care. A multidisciplinary approach, including individual and organizational components, is needed to improve patient safety culture. Methods. A cross-sectional study was conducted in January 2021 involving a total of 271 nurses in six tertiary hospitals. Data were collected from participants on nurse professionalism, work environment, communication, and patient safety culture. A multiple regression model was used to analyze variables influencing patient safety culture. Results. Factors affecting patient safety culture were nursing foundations for quality of care (β = 0.230, p &lt; 0.001 ), nurse manager ability, leadership, support of nurses (β = 0.294, p &lt; 0.001 ), and collegial nurse-physician relations (β = −0.138, p = 0.026 ) in the nursing work environment. Accuracy (β = 0.117, p = 0.007 ), shift communication (β = 0.128, p = 0.026 ), satisfaction (β = 0.283, p = 0.001 ), and timeliness (β = 0.239, p &lt; 0.001 ) of communication between healthcare professionals and nurses have a significant impact on patient safety culture. All these predictors accounted for 59% (R2) of patient safety culture awareness ( p &lt; 0.001 ). Conclusions. Enhancing patient safety culture requires a systematic and organizational approach that considers individual characteristics. Nurse managers play a crucial role in promoting patient safety by employing various communication channels and leading team education and training initiatives to foster collaboration among healthcare professionals. Implications for Nursing Management. The provision of patient safety education directly influences patient safety culture, and continuous education enables nurses to grow within the institution. To ensure effective communication in healthcare settings, nurse managers should prioritize shift communication, evaluate the accuracy of information exchange, and establish diverse communication channels, including social media platforms or business messengers, for internal hospital communication.

Status and Factors Affecting Patient Safety Culture at Dilla University Teaching Hospital: A Mixed-Method Cross-Sectional Study.

Patient safety culture is now at the forefront of the global health agenda and has been designated as a human right. Assessing safety culture is seen to be a prerequisite for improving safety culture in health-care organizations. However, no research has been conducted to examine the current study setup. Therefore, this study aims at assessing the status and factors influencing patient safety culture at Dilla University Teaching Hospital. This cross-sectional institutional-based study was conducted from February to March 2022 at Dilla University Hospital. The study used both qualitative and quantitative methods. A total of 272 health professionals were included in the survey. The qualitative data was collected using Key Informant Interviews and In-depth Interviews and 10 health professionals were selected purposively to meet the study objective. The overall composite positive patient safety culture response rate in the current study hospital was 37% (95% CI: 35.3, 38.8). Out of the 12 dimensions, teamwork within hospital units was the highest (75.3%), while frequency of event reporting was the lowest (20.7%) positive percentage response. Only two of the 12 dimensions scored above 50%. Factors affecting patient safety culture majorly at organizational and individual level were poor/low attitude of health professionals, poor documentation practice, and poor cooperation by clients, lack of training and continuous education, lack of standard operating procedure, Staff shortage and high work load. This study revealed that the overall composite positive patient safety culture response rate within the surveyed facility was alarmingly low compared to other hospitals in various countries. The results indicate that there is a need for improvement in areas such as event reporting, documentation, health-care workers' attitude, and staff training. Hospitals must prioritize patient safety by cultivating a strong safety culture through effective leadership, adequate staffing, and education to enhance overall patient care.

Factors Affecting Patient Safety in Working at the Madiun Hospital (RSUD Madiun)

Patient safety in hospitals is a service system in a hospital that provides safer patient care. The purpose of the study was to analyze the factors that affect patient safety in working. The research design used was quantitative with cross-sectional approach. The population of all nurses in Madiun Hospital was 195 respondents. The sample of some nurses was 131 respondents with purposive sampling. The results showed that there was an influence on the role of communication (p=0.001), environmental conditions (p=0.003), distractions at work (p=0.014), workload (p=0.042) and staff education (p=0.000). Multivariate analysis showed that the most influential variable on patient safety was staff education with a significance level of p=0.000 and B=0.068. It is expected that nurses in providing health services must improve the quality which will be able to provide comfort and quality services to patients in terms of improving patient safety.

Factors Affecting Patient Safety Culture among Health Professionals in Ilu Aba-Bora Zone, South West Ethiopia: A Mixed Method Study

Introduction: Unsafe medical care is a major source of morbidity and mortality throughout the world. In Ethiopian health system, the information about patient safety culture is limited in scope. The aim of this study is to assess patient safety culture and associated factors among Health professionals in public health facilities of Ilu Aba-bare zone, southwest Ethiopia.

Patient safety culture and attitudes among emergency care unit nurses in Türkiye.

Nurses have a key role in ensuring the safety of patients, reducing the likelihood of errors and improving patient outcomes. This study aimed to determine the factors affecting patient safety, with a focus on the culture and attitudes of nurses working in emergency units. This cross-sectional, descriptive, correlational study was conducted between 10 January and 30 August 2015 among 282 nurses who worked at emergency units of 19 hospitals in the north-central Black Sea Region of Türkiye Data were obtained using descriptive information forms, the Patient Safety Attitude Scale (PSAS) and the Patient Safety Culture Scale (PSCS). The mean total PSAS score was 152.26 [standard deviation (SD) 22.54; range 46-230], while the mean total PSCS score was 2.56 (SD 0.52; range 1-4). Around a quarter of the participants reported errors, such as medication errors and patient falls, which threatened patient safety in the emergency units. The case report forms were not filled when these errors occurred. Attitude and culture of nurses in hospital emergency units towards patient safety differed according to their sociodemographic and work-life characteristics, including being satisfied with working in the emergency room, quality of work-life balance, level of job satisfaction, and number of years working in the emergency room.

Factors affecting patient safety culture in the nursing section of a type C private hospital in Surakarta using structural equation modeling

Introduction: Patient safety culture is a high-quality health service that must be owned by all hospital staff, specifically for type C private hospitals. Therefore, this research selected seven factors influencing patient safety culture and made operational definitions based on references from preliminary research. The indicators used refer to Patient Safety Management Activities (PSMA) based on the International Patient Safety Goals (IPSG) principles regulated by the Minister of Health Regulation 11 of 2017. This research aims to identify hospital elements related to implementing a patient safety culture. It includes individuals, working conditions, work environment, management, awareness related to safety, safety culture, and PSMA. Methods: Data were collected from 215 respondents through independent questionnaires distributed online to two type C private hospitals in Surakarta City, where 160 nurses work in in-patient rooms and 55 nurses in the Emergency Room (ER). Data collected were analyzed using structural equation modeling (SEM), such as SmartPLS 3.0, to determine the relationship between seven factors: individual, working conditions, work environment, management, safety awareness, culture, and PSMA. Result: SEM test results in Factors affecting PSMA on the SEM test with a p-significant value of 0.05. A significant direct positive effect on PSMA is the factor of safety culture and work environment. Meanwhile, the indirect significant positive influence on PSMA comprises individual conditions, management, and safety-related awareness factors through safety culture factors. The process of not having a significant direct effect on PSMA is working conditions and safety-related awareness factors. Conclusion: The involvement of all parties with active roles in every healthcare system is expected to increase a safety culture which can then influence the increase in PSMA.

Experiences of Child and Adolescent Psychiatric Patients Boarding in the Emergency Department from Staff Perspectives: Patient Journey Mapping.

Over the past decade, healthcare providers nationwide have contended with a growing boarding crisis as pediatric patients await psychiatric treatment in emergency departments (EDs). COVID-19 has exacerbated this urgent youth mental health crisis, driving EDs to act as crisis units. Journey mapping is a robust methodology with which to examine strengths and challenges in patient care workflows such as boarding and emergency psychiatric care.Psychiatric, emergency medicine, and hospitalist providers serving patients boarding at a northeastern children's hospital participated in semi-structured qualitative interviews. Investigators conducted directed content analysis with an inductive approach to identify facilitators, barriers, and persistent needs of boarding patients, which were summarized in a patient journey map. Findings were presented to participants for feedback and further refinement.Quantitative data showed a three-fold increase in the number of patients who boarded over the past three years and a 60% increase in the average time spent boarding in the ED. Emergent qualitative data indicated three stages in the boarding process: Initial Evaluation, Admitted to Board, and Discharge. Data highlighted positive and negative factors affecting patient safety, availability of beds in pediatric hospital and psychiatric inpatient settings, high patient-provider ratios that limited staffing support, and roadblocks in care coordination and disposition planning.Patient journey mapping provided insight into providers' experiences serving patients boarding for psychiatric reasons. Findings described bright points and pain points at each stage of the boarding process with implications for psychiatric care and systemic changes to reduce boarding volume and length of stay.

The relationship between cultural sensitivity and levels of work interaction among emergency medical services staff in Iran

IntroductionProper implementation of primary medical care requires appropriate interaction between personnel and the patient. Cultural sensitivity refers to acceptance, openness, and respect for colleagues and patients, regardless of their culture and ethnicity. Due to the importance of cultural sensitivity in emergency medical services (EMS), this study aimed to investigate the status of intercultural sensitivity among EMS staff and its relationship with their levels of work interaction in the workplace. Materials and MethodsThis study is a descriptive-correlational study conducted in 2022 with the participation of the EMS staff of Bam University of Medical Sciences. Data were collected through the workforce diversity questionnaire (WDQ-II), and the multicultural sensitivity scale (MSS) by stratified random sampling. Content validity was determined using the opinions of experts and specialists, and the reliability of the tools was assessed using the test–retest method. FindingsThis study showed that intercultural sensitivity among EMS staff was not significantly different from the mean score, but work interaction was significantly higher than the mean. The Pearson correlation coefficient test results also indicated a significant inverse correlation between intercultural sensitivity and work interaction. ConclusionAccording to the findings, to reduce intercultural sensitivity, it is necessary to familiarize people with each other and transfer information on and awareness of different cultures in the region to the personnel. Therefore, it seems logical that improvement of the interaction between the treatment team, especially among staff of emergency medical services, should receive more attention as one of the factors affecting patient safety and care.

Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room.

To predict the amount of teamwork that takes place throughout a surgery, based on performing a preoperative safety standards (surgical safety checklist and surgical count) and to explore factors affecting patient safety and staff psychological safety during a surgery, based on interprofessional teamwork. This mixed methods study included quantitative and qualitative analyses. Quantitative data included 2,184 direct observations of surgical cases with regard to the performance of safety standards during surgeries in 29 hospitals, analyzed using multivariate binary logistic regressions. Qualitative data were obtained from an analysis of 25 semi-structured interviews with operating room (OR) clinicians and risk managers, using an inductive thematic analysis approach. Analysis of the OR observations revealed that a lack of teamwork in the preoperative "sign-in" phase doubled the chances of there being a lack of teamwork during surgery [odds ratio = 1.972, 95% confidence interval (CI) 1.741, 2.233, p < 0.001] and during the "time-out" phase (odds ratio = 2.142, 95% CI 1.879, 2.441, p < 0.001). Consistent presence of staff during surgery significantly increased teamwork, by 21% for physicians and 24% for nurses (p < 0.05), but staff turnover significantly decreased teamwork, by 73% for physicians (p < 0.05). Interview data indicated that patient safety and staff psychological safety are related to a perception of a collaborative team role among OR staff, with mutual commitment and effective interprofessional communication. Healthcare organizations should consider the key finding of this study when trying to identify factors that affect teamwork during a surgery. Effective preoperative teamwork positively affects intraoperative teamwork, as does the presence of more clinicians participating in a surgery, with no turnover. Other factors include working in a fixed, designated team, led by a surgeon, which functions with effective interprofessional communication that promotes patient safety and staff psychological safety.

Blockchain for Patient Safety: Use Cases, Opportunities and Open Challenges

Medical errors are recognized as major threats to patient safety worldwide. Lack of streamlined communication and an inability to share and exchange data are among the contributory factors affecting patient safety. To address these challenges, blockchain can be utilized to ensure a secure, transparent and decentralized data exchange among stakeholders. In this study, we discuss six use cases that can benefit from blockchain to gain operational effectiveness and efficiency in the patient safety context. The role of stakeholders, system requirements, opportunities and challenges are discussed in each use case in detail. Connecting stakeholders and data in complex healthcare systems, blockchain has the potential to provide an accountable and collaborative milieu for the delivery of safe care. By reviewing the potential of blockchain in six use cases, we suggest that blockchain provides several benefits, such as an immutable and transparent structure and decentralized architecture, which may help transform health care and enhance patient safety. While blockchain offers remarkable opportunities, it also presents open challenges in the form of trust, privacy, scalability and governance. Future research may benefit from including additional use cases and developing smart contracts to present a more comprehensive view on potential contributions and challenges to explore the feasibility of blockchain-based solutions in the patient safety context.

Patient safety measurement tools used in nursing homes: a systematic literature review

BackgroundAn increase in the number of older adults has highlighted the important issue of the safety of residents in nursing homes. This review aimed to review previous studies on patient safety of older adults living in nursing homes, analyze the tools used to measure it, and identify factors affecting patient safety of older adult residents in nursing homes.MethodsA literature search was conducted using EMBASE, PubMed, CINHAL, and COCHRANE. The main search terms were “nursing home” or “skilled nursing facility” or “long-term care facility” and “patient safety.” In total, 13,586 articles were identified. Two authors independently assessed the quality of each selected study using the Crowe Critical Appraisal Tool.ResultsTwenty-five studies were included in the analysis. There were a total of seven tools used to measure patient safety in nursing homes: the Nursing Home Survey on Patient Safety Culture (10 studies) and Hospital Survey on Patient Safety Culture (nine studies). Furthermore, the Nursing Home Survey on Patient Safety Culture-China, Safety Attitudes Questionnaire, Safety Attitudes Questionnaire in a Skilled Nursing Facility, Safety Attitudes Questionnaire-Ambulatory Version, and Modified Stanford Patient Safety Culture Survey Instrument were used in one study each. The most used tool among them was the Nursing Home Survey on Patient Safety Culture. Most tools used to measure patient safety in nursing homes were related to patient safety culture and employee attitudes.ConclusionOrganizational factors, such as the staff education system and the composition of appropriate personnel, should be strengthened to establish a patient safety culture in nursing homes, for which policy support is crucial.

Factors affecting patient safety culture in a university hospital under the universal health insurance system: A cross-sectional study from Japan.

We conducted a cross-sectional study of patient safety culture aimed at examining the factors that influence patient safety culture in university hospitals under a universal health insurance system. The Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality was used. The survey was distributed to 1066 hospital employees, and 864 responded. The confirmatory factor analysis showed a good fit of the results to the 12-composites model. The highest positive response rates were for "(1) Teamwork within units" (81%) and "(2) Supervisor/manager expectations and actions promoting patient safety" (80%), and the lowest was for "(10) Staffing" (36%). Hayashi's quantification theory type 2 revealed that working hours per week had the greatest negative impact on patient safety culture. Under a universal health insurance system, workload and human resources might have a significant impact on the patient safety culture.

Factors Affecting Patient Safety Culture from Nurses' Perspectives for Sustainable Nursing Practice.

Individual and group beliefs, attitudes, perceptions, competences, and behavioral patterns all contribute to the safety culture of a healthcare company. The study’s goal is to assess nurses’ perceptions of elements that influence patient safety culture in order to promote long-term nursing practice. A descriptive cross-sectional study design was done among a sample of 146 nurses who were recruited from one hospital in Egypt. They completed a self-administered, printed questionnaire. The questionnaire assessed participants’ socio-demographic data and their perception regarding patient safety culture for sustainable nursing practices. The findings revealed that nursing staff had a high perception regarding patient safety culture a with mean score (159.94 ± 7.864). Also, the highest percentage (74.66%) of had no safety events reported yearly. Creating a unit-specific patient safety culture suited to the competences of the unit’s RNs in patient safety practice would be crucial to increasing and sustaining high levels of patient safety attitudes, skills, and knowledge among the unit’s RNs, influencing patient safety. When implementing interventions to promote patient safety and reporting culture in hospitals, policymakers, hospital administrators, and nurse executives should take the current findings into account. A multidimensional network intervention addressing many elements of patient safety culture and integrating different organizational levels should be implemented to enhance patient safety and a no-blame culture.

간호사의 조직몰입, 의사소통 및 환자안전역량이 환자안전문화에 미치는 영향

This study aimed to identify the factors affecting patient safety culture by focusing on nurses' organizational commitment, communication competence, and patient safety competency. The study was conducted with 168 nurses from 30 general hospitals located in Seoul and 3 provinces. Using the SPSS program, descriptive statistical analysis, independent sample t-test, ANOVA analysis, correlation analysis, and regression analysis were performed. We found that organizational commitment (β=.48, p&lt;.001) and patient safety competency (β=.35, p&lt;.001) had a statistically significant effect in influencing patient safety culture, and the total explanatory power was 48.7%. To increase nurses' formation of a patient safety culture, the development of systematic and diverse educational programs that increase nurses' organizational commitment and patient safety competency are warranted.