Patient Involvement In Safety Research Articles

The Family’s Contribution to Patient Safety

Person- and family-centered care is one of the recommendations to achieve quality of care and patient safety. However, many health professionals associate the family with insecurity in care. To analyze, based on nurses' statements, the advantages and disadvantages of the family's presence in hospitals for the safety of hospitalized patients. This was a qualitative interpretative study based on James Reason's risk model, conducted through semi-structured interviews with 10 nurses selected by convenience. A content analysis was performed using Bardin's methodology and MAXQDA Plus 2022 software. We identified 17 categories grouped according to the representation of the family in patient safety: The family as a Potentiator of Security Failures (7) and Family as a Safety Barrier (10). The higher number of categories identified under Family as a Safety Barrier shows that nurses see strong potential in the family's involvement in patient safety. By identifying the need to intervene with and for families so that their involvement is safe, we observed an increase in the complexity of nursing care, which suggests the need to improve nursing ratios, according to the participants.

Undertaking risk and relational work to manage vulnerability: Acute medical patients’ involvement in patient safety in the NHS

Over the last decade a wealth of studies have explored the way that patients are involved in patient safety internationally. Most begin from the premise that patients can and should take on the role of identifying and reporting safety concerns. Most give little attention, however, to the impact of the patient's health status and vulnerability on their ability to participate in their safety.Drawing on qualitative interviews with 28 acute medical patients, this article aims to show how patients’ contributions to their safety in the acute medical context are less about involvement as a deliberate intervention, and more about how patients manage their own vulnerability in their interactions with staff.Our analysis is underpinned by theories of vulnerability and risk. This enables us to provide a deeper understanding of how vulnerability shapes patients’ involvement in their safety. Acute medical patients engage in reassurance-seeking, relational and vigilance work to manage their vulnerability. Patients undertake reassurance seeking to obtain evidence that they can trust the organisation and the professionals who work in it and relational and vigilance work to manage the vulnerability associated with dependence on others and the unpredictability of their status as acute medical patients. Patients are made responsible for speaking up about their care but simultaneously, by virtue of the expectations of the sick role and their relational vulnerability, encouraged to remain passive, compliant or silent. We show how risk frames the extent to which patients can activate their role in creating patient safety at the point of care. Foregrounding the theory of vulnerability, the concept of the sick role and the relationship of both to risk offers new insights into the potentials and limits of patient involvement in patient safety in the acute care context.

"Should I Say Something?": A Simulation Curriculum on Addressing Lapses in Professionalism to Improve Patient Safety.

Medical students may witness lapses in professionalism but lack tools to effectively address such episodes. Current professionalism curricula lack opportunities to practice communication skills in addressing professionalism lapses. We designed a simulation curriculum to introduce professionalism expectations, provide communication tools using elements of the Agency for Healthcare Research and Quality TeamSTEPPS program, and address observed professionalism lapses involving patient safety in hierarchical patient care teams. Students were surveyed on knowledge, skills, and attitude regarding professionalism before, immediately after, and 6 months after participation. Of 253 students, 70 (28%) completed baseline and immediate postsurveys, and 39 (15%) completed all surveys. In immediate postsurveys, knowledge of communication tools (82% to 94%, p = .003) and empowerment to address residents (19% to 44%, p = .001) and attendings (15% to 39%, p < .001) increased. At 6 months, 96% of students reported witnessing a professionalism lapse. The curriculum was successful in reported gains in knowledge of communication tools and empowerment to address professionalism lapses, but few students reported using the techniques to address witnessed lapses in real life.

The Relationship Between Workplace Incivility and Patient Safety in Pediatric Nurses.

Workplace incivility may directly influence nurses' involvement in patient safety; however, research on this topic in the pediatric setting has yet to be established. The purpose of this study was to address the prevalence of workplace incivility in pediatric settings in Saudi Arabia (SA) and examine its impact on patient safety culture. A cross-sectional study design was used. Surveys, including the Nursing Incivility Scale and Hospital Survey on Patient Safety Culture, were sent to nurses across 6 pediatric units in Taif, SA. A total of 300 nurses completed the surveys. A significant negative modest correlation was found between incivility and patient safety domains ( P < .05). A higher stress score was associated with older age (>35 years), Saudi nationality, and subdegree education. This study found that pediatric nurses experience high rates of incivility, mostly originating from patients and their families.

The Safety Showdown: Perceptions and Practice Change of Inpatient Caregivers After a Patient Safety Escape Room.

Educational escape rooms actively engage learners and foster teamwork. It is unclear if they result in nursing practice change. Three hundred ninety-eight nursing and ancillary caregivers participated in an escape room involving patient safety and fall prevention concepts. An average rating of 4.3 out of 5 on the escape room perception scale was obtained via a postsurvey, showing positive perceptions of the event. In a delayed postsurvey, participants discussed resultant patient safety practice changes.

Involvement of companions in patient safety in pediatric and neonatal units: scope review.

to describe scientific evidence on the involvement of companions in patient safety, from their own perspective and health professionals' perspective in neonatal and pediatric units. scoping review carried out according to The Joanna Briggs Institute's recommendations, in eight databases, following the Preferred Reporting Items checklist for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, between 2011 and 2021. the 13 studies included highlighted the importance of companions' involvement in patient safety and the prevention of adverse events. However, they pointed out failures in communication and weakness in the training of professionals, which were obstacles to their involvement. The strengthening of health education, multidisciplinary rounds and educational technologies were highlighted as strategies to expand the involvement of companions. this study directs elements for health professionals and managers to rethink the companions' role in patient safety and development of collective strategies.

Safety Culture Approach For Healthcare And Nursing Institutions

Abstract There are a few ways how to increase the rate of employees’ safety culture at an institution, one of these is a positive safety culture, which includes their proper attitudes, safety-related values, staff members’ professional competences, and their willingness to work. The key element in the offering of quality and safe services in healthcare is a positive safety quality according to definitions. The aim of the current paper is to identify potential predictors of employees’ safety behaviour and determine safety culture subcultures that support operational manager to develop proactive safety management systems (SMSs) and offer safety of patients and employees. Two independent surveys were the basis of the new proposed approach. Quantitative method approach was selected to investigate safety culture subcultures in Estonian healthcare and nursing institutions. According to the proposed approach, there are crucial subcultures (e.g., just, reporting, learning, professional competences, and psychosocial well-being), which should be developed and periodically evaluated within an organisation. This measurement should have a clear and shared understanding of patient safety goals and occupational health and safety (OHS). The general management of organisations should consider implementation of assessment as a proactive approach to use the SMSs. The sustainability and proactivity of the proposed approach lies in defining action plans for continuous improvement and employees’ involvement in patient safety and OHS management.

Desenvolvimento participativo de tecnologia educacional em busca da segurança do paciente na maternidade

ABSTRACT Objectives: to develop a booklet as an educational technology, together with health professionals, patients and companions, aiming at their involvement in patient safety in maternity hospitals. Methods: a qualitative convergent care study, carried out in three stages at a maternity hospital in Belo Horizonte. The booklet construction took place between February and April 2021, with 13 professionals, 06 companions and 11 patients. Results: data content analysis was performed, creating three categories: Knowledge and experiences about patient and newborn safety in maternity hospitals; Challenges for involving patient and companion in safety actions; Assessment of patients, companions and professionals on the booklet construction process. The booklet construction involved the participation of health professionals, users and companions in all stages of the process. Final considerations: the participatory process enabled the creation of educational technology for the involvement of patients and companions in patient safety actions.

Patient-completed safety checklists as an empowerment tool for patient involvement in patient safety: concepts, considerations and recommendations

The application of safety checklists to healthcare settings to help systematise routines and improve communication between healthcare professionals has proven to be effective in reducing errors, complications, mortality and hospitalisation time. There is a new call to extend the checklist concept to develop safety checklists that can be used by patients to help empower their involvement in safety practices. Only a handful of studies around patient-completed checklists exist, but those that do indicate a positive impact on patient empowerment and involvement in safety-related behaviours. In this article, we present the concept of patient-completed checklists and provide a review of the existing evidence, highlighting important design and implementation considerations, and making recommendations for future research and development.

Perspectives Of Health Care Professionals On Patient Involvement In Patient Safety At Tertiary Care Women’s Hospitals In Colombo District

Perspectives Of Health Care Professionals On Patient Involvement In Patient Safety At Tertiary Care Women’s Hospitals In Colombo District

Comparison study of Health Care Professionals attitudes toward supporting patient involvement in patient safety in two women’s hospitals in Colombo district

Comparison study of Health Care Professionals attitudes toward supporting patient involvement in patient safety in two women’s hospitals in Colombo district

Newly Graduate Registered Nurses’ Experiences of Transition to Clinical Practice: A Systematic Review

New graduate registered nurses encounter many difficulties such as unexpected role, stress and lack of support. Therefore, many of them consider leaving their nursing roles. This systematic review aims to explore the experiences of newly graduate registered nurses about the transition from student nurse to graduate nurse in clinical practice. A qualitative systematic review was conducted using inclusion and exclusion criteria and PRISMA guideline. Twenty-three studies are included in the review and analysed using thematic analysis. The four researchers managed quality appraisal and data extraction. Of 23 studies included in the review, 22 were qualitative studies, and one was mixed methods. Following the thematic analysis, four themes were identified: (i) the impact of the undergraduate experience (ii) mental stress and coping strategies (iii) Existing knowledge of organizational support and (iv) professional accountability and competency. Findings show that newly graduate registered nurses experience high levels of turnover due to work stress, lack of support and inadequate undergraduate preparation. The successful transition is influenced by educational preparation, hospital orientation, and organizational support. Further research is required to explore the experiences of newly graduate registered nurses in developing countries, as there is limited research, which has considered nursing education, healthcare facilities, and cultural influences in these countries. New graduate registered nurses play a significant role in the provision of patient care and enhancing patient safety. This review explored their experiences about the transition from student to registered nurses to recommend comprehensive practical guidelines to support their involvement in patient safety and to provide insight for nurse’s leaders to understand the retention issues for new nurses. In addition to helping undergraduate nursing education programs to improve their strategies in preparing graduates for entry into professional practice.

Value Added: Trainee Involvement in Patient Safety and Quality Improvement.

Value Added: Trainee Involvement in Patient Safety and Quality Improvement.

Urology Resident Involvement in Patient Safety and Quality Improvement Activities.

To assess current urology resident engagement in patient safety and quality improvement (PSQI) and how to improve resident involvement in PSQI. Overall urology resident participation in PSQI is low, especially when compared to other non-surgical residency programs. Multiple methods have been successfully implemented to increase resident participation in PSQI. Patient safety and quality improvement are extremely important to the progression of both urology and the healthcare community. True and meaningful participation in PSQI is lacking for many urology residents. However, there are easily adopted methods to improve resident involvement in this area of healthcare. These methods include direct communication and access between residents and hospital PSQI boards, resident-led safety councils, monetary incentives, formal training, and PSQI resident support teams.

107. GETTING TO THE ROOT CAUSE: RESIDENT ENGAGEMENT IN A MORBIDITY, MORTALITY, &amp; IMPROVEMENT CURRICULUM WITHIN A LARGE PEDIATRIC TRAINING PROGRAM

Residents are exposed to medical errors during their training. The ACGME emphasizes the importance of patient safety and medical error analysis in a residency curriculum. Understanding root cause analysis (RCA) is an important component of a morbidity, mortality, and improvement (MMI) curriculum, enriching patient safety education. The objectives are to (1) engage residents in a mock RCA, (2) increase resident comfort in reporting medical errors, and (3) increase resident awareness of patient safety opportunities. Our MMI curriculum incorporated a mock-RCA workshop which highlighted a medical error that occurred due to poor patient hand-off. Residents assumed multiple roles (including that of chief quality officer) and were guided through an RCA. They identified the safety event, deviations from standard of care, and corrective actions to mitigate recurrence. Using a 5-point Likert scale survey, we assessed residents on their understanding of the RCA process, confidence in identifying safety events and deviations in care, willingness to report a medical error, and perceived ability to identify QI opportunities in the workplace. 100% strongly agreed or agreed that they had a better understanding of the RCA process (n = 20). 95% either strongly agreed or agreed that they felt confident in identifying safety events and deviations in care. Regarding likelihood to self-report a medical error or one made by a colleague, 95% strongly agreed or agreed with both statements. All residents strongly agreed or agreed with their ability to identify QI opportunities in day-to-day patient care. Lastly, 85% either strongly agreed or agreed that they had become more actively interested in participating in a QI project involving patient safety. Medical errors provide opportunities for residents to learn and take corrective actions. An MMI curriculum, focused through the lens of an RCA, is an opportunity for residents to gain a better understanding of how medical errors are identified and engage residents in QI science on a hospital-wide level.

Patients\u2019 and healthcare workers\u2019 recommendations for a surgical patient safety checklist \u2013 a qualitative study

BackgroundPatients’ involvement in patient safety has increased in healthcare. Use of checklists may improve patient outcome in surgery, though few have attempted to engage patients’ use of surgical checklist. To identify risk elements of complications based on patients’ and healthcare workers’ experiences is warranted. This study aims to identify what the patients and healthcare workers find to be the risk elements that should be included in a patient-driven surgical patient safety checklist.MethodA qualitative study design where post-operative patients, surgeons, ward physicians, ward nurses, and secretaries from five surgical specialties took part in focus group interviews. Eleven focus groups were conducted including 25 post-operative patients and 27 healthcare workers at one tertiary teaching hospital and one community hospital in Norway. Based on their experiences, participants were asked to identify perceived risks before and after surgery. The interviews were analysed using content analysis.ResultsSafety risk factors were categorised as pre-operative information: pre-operative preparations, post-operative information, post-operative plans and follow-up. The subcategories under pre-operative information and preparations were: contact information, medication safety, health status, optimising health, dental status, read information, preparation two weeks before surgery, inform your surgical ward, planning your own discharge, preparation on admission and just before surgery. The subcategories under post-operative information, further plans and follow-up were: prevention and complications, restriction and activity, medication safety, pain relief, stomach functions, further care and appointments. Both healthcare workers and patients express the need for a surgical patient safety checklist.ConclusionA broad spectre of risk elements for a patient safety checklist were identified. Developing a surgical safety checklist based on these risk elements might reduce complications and unwanted errors.Trail registrationThe study is registered as part of a clinical trial in ClinicalTrials.gov: NCT03105713.

A Mixed-Methods Study on Patient Safety Insights of New Graduate Registered Nurses.

New graduate nurses transition with limited experience, and with anxiety and stress. They present an increased risk of contributing to preventable errors or adverse events. The purpose was to develop an understanding of new graduate registered nurses' (RNs) patient safety knowledge and actions within the first year of registration. The longitudinal mixed-methods study was conducted using a questionnaire delivered at 3 time points (n = 68). Qualitative data were collected by semistructured interviews (n = 11). Self-reported knowledge of medical error decreased over the 3 time points. Themes emerging from qualitative data include patient safety and insights, time management, making a mistake, experiential learning, and transition. Medical errors and time management persist during transition to the RN role. New graduates reported moderate knowledge of safety and quality issues; however, questioning their own abilities overshadowed growth in their involvement in patient safety.

Investigating the feasibility of a patient feedback tool to improve safety in Australian primary care: a study protocol

IntroductionPatients are a valuable source of information about ways to prevent harm in healthcare, and can provide feedback about the factors that contribute to safety incidents. The Primary Care Patient...

Selecting, refining and identifying priority Cochrane Reviews in health communication and participation in partnership with consumers and other stakeholders

BackgroundPriority-setting partnerships between researchers and stakeholders (meaning consumers, health professionals and health decision-makers) may improve research relevance and value. The Cochrane Consumers and Communication Group (CCCG) publishes systematic reviews in ‘health communication and participation’, which includes concepts such as shared decision-making, patient-centred care and health literacy. We aimed to select and refine priority topics for systematic reviews in health communication and participation, and use these to identify five priority CCCG Cochrane Reviews.MethodsTwenty-eight participants (14 consumers, 14 health professionals/decision-makers) attended a 1-day workshop in Australia. Using large-group activities and voting, participants discussed, revised and then selected 12 priority topics from a list of 21 previously identified topics. In mixed small groups, participants refined these topics, exploring underlying problems, who they affect and potential solutions. Thematic analysis identified cross-cutting themes, in addition to key populations and potential interventions for future Cochrane Reviews. We mapped these against CCCG’s existing review portfolio to identify five priority reviews.ResultsPriority topics included poor understanding and implementation of patient-centred care by health services, the fact that health information can be a low priority for health professionals, communication and coordination breakdowns in health services, and inadequate consumer involvement in health service design. The four themes underpinning the topics were culture and organisational structures, health professional attitudes and assumptions, inconsistent experiences of care, and lack of shared understanding in the sector. Key populations for future reviews were described in terms of social health characteristics (e.g. people from indigenous or culturally and linguistically diverse backgrounds, elderly people, and people experiencing socioeconomic disadvantage) more than individual health characteristics. Potential interventions included health professional education, interventions to change health service/health professional culture and attitudes, and health service policies and standards. The resulting five priority Cochrane Reviews identified were improving end-of-life care communication, patient/family involvement in patient safety, improving future doctors’ communication skills, consumer engagement strategies, and promoting patient-centred care.ConclusionsStakeholders identified priority topics for systematic reviews associated with structural and cultural challenges underlying health communication and participation, and were concerned that issues of equity be addressed. Priority-setting with stakeholders presents opportunities and challenges for review producers.

"I'm Trying to Stop Things Before They Happen": Carers' Contributions to Patient Safety in Hospitals.

Patient safety policies increasingly encourage carer (i.e., family or friends) involvement in reducing health care–associated harm in hospital. Despite this, carer involvement in patient safety in practice is not well understood—especially from the carers’ perspective. The purpose of this article is to understand how carers of adult patients perceived and experienced their patient safety contributions in hospital. Constructivist grounded theory informed the data collection and analysis of in-depth interviews with 32 carers who had patient safety concerns in Australian hospitals. Results demonstrated carers engaged in the process of “patient-safety caring.” Patient-safety caring included three levels of intensity: low (“contributing without concern”), moderate (“being proactive about safety”), and high (“wrestling for control”). Carers who engaged at high intensity provided the patient with greater protection, but typically experienced negative consequences for themselves. Carers’ experiences of negative consequences from safety involvement need to be mitigated by practice approaches that value their contributions.