Patient Safety Management Research Articles

Mediating Effects of Resilience between Influence of Emotional Labor and Patient Safety Management Activities on Job Satisfaction, Nurses in Small-Medium sized Hospitals

목적 본 연구에서는 지역 중소병원 간호사의 감정노동, 환자안전관리활동이 직무만족도에 미치는 영향을 확인하고, 이들 관계에서 회복탄력성의 매개효과를 파악하기 위함이다. 방법 2개 종합병원에서 근무하는 간호사 170명을 대상으로 구조화된 자가 설문지를 이용하였다. 수집된 자료는 SPSS/WIN 21.0 통계프로그램 t-test, ANOVA, Pearson s correlation coefficients, Mediating effects regression 이용하여 분석하였다. 결과 대상자의 감정노동과 환자안전관리활동(r=.327, p<.001), 직무만족(r=.411 p<.001), 회복탄력성(r=.565, p<.001)은 모두 통계적으로 유의한 정(+)의 상관관계를 나타내었다. 회복탄력성과 직무만족(r=.466, p<.001), 환자안전관리활동 간에도 통계적으로 유의한 정(+)의 상관관계를 보였다(r=.367, p<.001). 감정노동과 직무만족도사이에서 매개효과를 분석한 결과(β=.22, p=0.12)과 회복탄력성(β=.34, p<.001) 모두 직무만족에 유의한 영향을 미치는 것으로 확인되었다. Sobel test 결과 유의하게 나타났다(Z=3.71, p<.001). 결론 이를 통해 간호사의 감정노동을 감소시키고 직무만족에 영향을 미치는 회복탄력성을 향상시키기 위해 다양한 프로그램 적용의 필요성을 시사하고 있다.

The Evolution of the Anesthesia Patient Safety Movement in America: Lessons Learned and Considerations to Promote Further Improvement in Patient Safety.

Ellison C. Pierce, Jr., M.D., and a small number of specialty leaders and scientists formed a remarkable, diverse team in the mid-1980s to address a dual crisis: a safety crisis for anesthetized patients and a medical malpractice insurance crisis for anesthesiologists. This cohesive team's efforts led to the formation of the Anesthesia Patient Safety Foundation, the American Society of Anesthesiologists's Committees on Standards of Care and on Patient Safety and Risk Management, and the society's Closed Claims Project. The commonality of leaders and members of the Anesthesia Patient Safety Foundation and American Society of Anesthesiologists initiatives provided the strong coordination needed for their efforts to effect change, introduce standards of care and practice parameters, obtain financial support needed to grow patient safety-oriented new knowledge, integrate industry and other relevant leaders outside of anesthesiology, and involve all anesthesia professions. By implementing successful patient safety initiatives, they promoted the recognition that anesthesiology and patient safety are inextricably linked.

A STUDY ON PATIENT SAFETY MANAGEMENT’S KNOWLEDGE, ATTITUDE, CONFIDENCE IN PERFORMANCE, AND PRACTICE DURING PEDIATRIC-ADOLESCENT NURSING CLINICAL PRACTICE

This descriptive study was conducted to investigate nursing college students’ level of patient safety management during the pediatric-adolescent nursing clinical practice courses. This study aimed to provide a baseline data for developing systematic nursing educational curriculum for the enhancement of competence in nursing college students’ fundamental patient safety nursing intervention. The participants consisted of 372 senior nursing college students who have had clinical practice at a nursing college in G metropolitan city. The data was collected from December 1 to 28th, 2019 at the end point of their clinical training education in nursing college, and convenience sampling method was used. The results of this study indicated that the ratio of correct answers of PSM-K was 7.30 out of 10, PSM-A was 3.76, PSM-CP was 3.92, and PSM-P was 4.21 out of 5 points. In terms of the correlations between PSM-K, PSM-A, PSM-CP, and PSM-P, significant positive correlations existed between PSM-K and PSM-A(r=.28, p&lt;.001), PSM-CP and PSM-K(r=.19, p&lt;.001), PSM-CP and PSM-A(r=.48, p&lt;.001), PSM-P and PSM-A(r=.37, p&lt;.001), and PSM-CP and PSM-P(r=.36, p&lt;.001). Therefore, to enhance the nursing college students’ competence in patient safety nursing intervention, nursing college students must experience various exercises and training for patient safety management during the clinical practicum as well as with scenario-based simulation. The nursing education facilities should develop educational contents about patient safety for nursing college students.

The Factors Impacting Nurses Awareness on Prevention Healthcare-Associated Infections: A Systematic Review

Background: Healthcare-Associated Infections (HAIs) are significant causes of illness and mortality, and nurses are healthcare professionals with the most consistent contact with patients, therefore nurses need to possess adequate knowledge, and awareness.&#x0D; Aim: this study aim to analyze factors impacting nurses' awareness of the prevention of HAIs, such as their knowledge, attitude, and practice compliance.&#x0D; Methods: A systematic review was conducted from the sources of data collection, namely Proquest, Science Direct, Pubmed, and Google Scholar from 2011-2020, with English guidelines used to review the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.&#x0D; Results: Data were obtained through a questionnaire survey, direct observation, and self-report from 4329 nurses with a total of 12 inclusion criteria. The result showed that a significant number of nurses do not possess an acceptable level of knowledge and practice, although nurses have a positive attitude. Hand hygiene and the other protective personal equipment need to be used by nurses and other health personal to prevent Urinary Tract Infection, respiratory, and Surgical Site Infection in the hospital. &#x0D; Conclusion: nurses need to possess the right knowledge, attitude, and guidelines. Standard precaution is important for patient safety management, nurses need to be adequately trained to increase awareness.&#x0D;

Tapentadol and Oxycodone/Naloxone Prescribing Patterns in Primary Health Care in Catalonia, Spain: A Cross-Sectional Study.

ObjectiveTo characterize the use of tapentadol and the combination oxycodone/naloxone in primary health care. Data on their use and possible misuse will allow the identification of risk factors and to design protocols to reduce and prevent avoidable harm to patients being treated for pain.DesignA descriptive, cross-sectional and multicenter study was performed.SettingFifty-three primary health care teams, which provides healthcare for 1,300,000 inhabitants.PatientsA total of 1840 patients had active prescriptions of tapentadol and 985 of oxycodone/naloxone.MethodsDemographic (age, sex) and clinical (glomerular filtration rate; active liver disease; dosing and duration of treatment), prescribed daily dose (according to age, sex, length of treatment), concomitant analgesic treatment and diagnosis. Patient information was obtained from medical records.ResultsMost of the patients were women (>74.0% in both cases), and the average age was 69.3 years (women: 70.1±13.2; men: 66.7±13.9 years) in the case of tapentadol and 70.6 years (women: 64.0±13.6; men: 72.6±14.3 years) in the case of oxycodone/naloxone. Only 12.2% of patients taking tapentadol and 12.1% taking oxycodone/naloxone had a normal renal function. In both cases, 4.1% of patients had active liver disease. The average length of treatment was 246.4 days in oxycodone/naloxone and 199.0 days in tapentadol. It was recorded that 85.1% of patients in the case of tapentadol and 89.0% in the oxycodone/naloxone had at least another drug prescribed for pain. About 42.2% of patients treated with tapentadol and 34.4% of patients treated with oxycodone/naloxone had associated neuralgia as a diagnosis.ConclusionThe pattern of use and profile of patients with tapentadol and oxycodone/naloxone had more similarities than differences, and suggested that prescribing practice, and monitoring should be assessed regularly to ensure patient safety and effective management of pain.

Factors Influencing Patient Safety Competency on Confidence in Patient Safety Management in Dental Hygiene Student

Objectives: The study surveyed 150 dental hygiene students to find out the factors influencing Patient safety competency on confidence in patient safety management in dental hygiene student. Methods: In general characteristics, patient safety management was investigated patient safety knowledge, attitude, skill and studied using tools of patient safety competency on confidence. Results: Research shows that factors influencing patient safety competency on confidence are patient safety knowledge and skill. Conclusions: As a result, it is necessary to provide dental hygiene student with a patient safety-related education program that can be used in the field of practice.

Nurse Manager's Experience in Patient Safety Quality Control in Inpatient Wards: Systematic Review

Background: In the inpatient setting, the estimated safety incidence varies in the range of 10% to 99%. Patient safety as part of the quality indicators of health services in hospitals must be quality controlled. Nurse managers in managing patient safety quality control to carry out their roles and functions to achieve patient safety. The purpose of this systematic review is to see a description of the experience of nurse managers in controlling the quality of patient safety in inpatient rooms. Methods: Systematic literature search through EBSCO, Pub-Med, Science Direct and ProQuest databases using relevant keywords based on research topics and titles. The selection of articles used the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyzes) diagram method, with a total of 2,692 articles. Results: From 5 articles revealing the efforts made by nurse managers, nurse managers faced, nurse managers are responsible for the work and nurse managers' expectations of patient safety quality control. The findings from this systematic show that nurse managers have unique experience in patient safety quality control, patient quality control in the ward has no effect on improving health services in hospitals.

Structural equation modeling for identification of patient safety antecedents in primary care

BackgroundPatient safety is defined as an activity that minimizes and removes possible errors and injuries to patients. A number of factors have been found to influence patient safety management, including the facilities available in the practice, communication and collaboration, education regarding patient safety and generic conditions. This study tested a theoretical model of patient safety interventions based on safety antecedents.MethodsMedical professionals were surveyed using a questionnaire developed by Gaal et al. The results were analyzed with SPSS 20 and AMOS. A hypothetical model of direct and indirect effects on patient safety in a primary care environment was created and analyzed using structural equation modeling (SEM).ResultsSEM proved to be an effective tool to analyse safety in primary care. The facilities in the practice appear to have no significant influence on patient safety management in the case of female respondents, those below mean age, those who are not GPs (general practitioner) and respondents not working in counselling centres.ConclusionsThe integrated safety model described in the study can improve patient safety management.

Working Experience of Managers Who Are Responsible for Promoting and Monitoring Patient Safety in South Korea: Focusing on Small- and Medium-Sized Hospitals.

This study explored the working experience of patient safety managers (PSMs) in small- and medium-sized hospitals (SMHs). A qualitative study comprising 3 focus group discussions (6 people each) was conducted. Patient safety managers working in SMHs-hospitals with 100 to 300 beds-were included. Researchers analyzed the transcribed script, and a conventional content analysis was performed to describe PSMs' working experience. All the PSMs were nurses and with an average (SD) work experience of 1.51 (1.02) years. Five core themes and 17 subthemes were derived. The PSMs reported that it was difficult to perform patient safety tasks alone and cooperate with other departments. Because of members who did not acknowledge PSMs' authority as experts, PSMs experienced identity confusion. Lack of an established patient safety culture in SMHs hindered the PSMs from performing patient safety-related duties. The government continues to train PSMs and provide materials; however, they are not suitable for SMHs and thus cannot be used. The PSMs hoped to overcome the system's initial phase and become professionals. Patient safety managers faced difficulties because of the lack of guidelines, training, and systems. Nevertheless, they have attempted to overcome these problems themselves, so they can be recognized as professionals. This study's findings can be used as basic data to provide differentiated support for PSMs, based on hospital size.

Pilot Testing of a Nurse-Led Basic Symptom Self-management Support for Patients Receiving First-Line Systemic Outpatient Anticancer Treatment: A Cluster-Randomized Study (Symptom Navi Pilot Study).

The Symptom Navi Program (SNP) is a nurse-led intervention supporting basic symptom self-management for patients with any cancer diagnosis. The SNP has been accepted by patients and healthcare professionals alike. The aims of this study were to pilot the SNP and evaluate patient-reported symptom outcomes, nursing support for symptom management, and patient safety. Using a cluster-randomized design, we randomized centers to the intervention (SNP) or control group (usual care). Adult patients starting first-line systemic cancer treatment were included. The primary outcome was the change in symptom interference with daily functions from treatment onset to 16 weeks. Secondary outcomes included changes in symptom severity, symptom burden, self-efficacy, and perceived symptom management support and patient safety. We used linear and logistic mixed-effects models to pilot-test differences in mean changes between groups. The trial was registered with ClinicalTrials.gov (NCT03649984). Changes in symptom interference with daily functions did not differ (mean difference at 16 weeks: -0.50; 95% confidence interval, -1.38 to 0.38; P = 0.25) between SNP (3 centers, 49 patients) and control (5 centers, 85 patients) as for all other outcomes. No adverse events were reported. Our preliminary findings did not indicate an effect of the SNP on patient-reported symptom outcomes, self-efficacy, or symptom management support. Inadequate power and SNP components (eg, insufficient training, low number of follow-up consultations) may be attributed to the lack of an observed effect. The SNP training content and intervention procedures merit reconsideration.

The hand-brain-heart connection: ICU nurses' experience of managing patient safety during COVID-19.

BackgroundCOVID‐19 has challenged critical care nursing through increased critical care service utilization. This may have a profound impact on intensive care unit (ICU) nurses' ability to maintain patient safety. However, the experiences of ICU nurses in managing patient safety during an infectious disease outbreak remains unexplored.Aims and objectivesTo explore ICU nurses' narratives in managing patient safety in the outbreak ICUs during the COVID‐19 pandemic.DesignA narrative inquiry design.MethodsA purposive sample of 18 registered nurses who practiced in the outbreak ICUs during the COVID‐19 pandemic were recruited between June and August 2020. Individual semi‐structured interviews were conducted, transcribed verbatim, and narratively analysed.ResultsFindings reviewed an overarching anatomy‐specific storyline of a ‘hand‐brain‐heart’ connection that describes nurses' experience with managing patient safety during the COVID‐19 pandemic. Firstly, stories on ‘the hands of clinical practice’ revealed how critical care nursing is practiced and adapted by ICU nurses during the pandemic. In particular, ICU nurses banded together to safeguard patient safety by practicing critical care nursing with mastery. Secondly, stories on ‘the brain of psychosocial wellness’ highlights the tumultuous impact of COVID‐19 on the nurses' psychosocial well‐being and how nurses demonstrated resilience to continually uphold patient safety during the pandemic. Lastly, stories on ‘the heart of nursing’ drew upon the nurses' intrinsic professional nursing identity and values to safeguard patient safety. Specific patient tales further boosted the nurses' commitment to render safe nursing care during the pandemic.ConclusionsThrough their stories, ICU nurses reported how they continually seek to uphold patient safety through clinical competence, resilience, and heightened nursing identity.Relevance to clinical practiceICU nurses require sustainable clinical resources and references such as clinical instructors, as well as visible psychosocial support channels, for ICU nurses to continue to uphold patient safety during COVID‐19.

COVID-19 Pandemic Impacts Decision-Making and Psychosocial Behavior in Women Seeking Fertility Treatment in APAC—an ASPIRE Patient Experience Report

Background: ASPIRE (Asia-Pacific Initiative on Reproduction) aims to develop a “patient-centered” guide to provide fertility treatment based on patient preferences, needs, and concerns during and beyond the SARS-Cov-2 pandemic. Methods: Women, aged 20–45 years old, trying to conceive for more than 6 months and contemplating for pregnancy including IVF treatment. A country wise analysis of patient behavior, attitudes and concerns, reasons for disruption of treatment and availability of assistance from fertility clinics during SARS-Cov-2 pandemic was performed. Six problem statements addressing patient concerns were identified and corresponding solutions to improve patient experience were formulated. A two-tier recommendation was developed. Tier 1 comprises recommendations in which the rate of “absolutely agree” responses were [Formula: see text]60%, whereas tier 2 refers to recommendations in which the rate of “absolutely agree” plus “agree” together was &gt;60%. Results: Women in countries that have better infection control and are living a new normal were less worried about the pandemic influencing their lifestyle and finances. The proportion of women choosing not to continue IVF/IUI treatment during COVID-19 was similar across countries. Sixty-five percent of women in Group A intend to continue treatment during COVID-19 pandemic. Nine out of 10 patients are expected to resume or start treatment once fertility clinics are accessible. A patient-centered guide focusing on management of patient safety concerns, reduction in difficulty of access to hospitals, prioritization of patients, provision of emotional support, and improvement in patient education and acceptance of remote health services was developed. Conclusion: This ASPIRE patient experience report highlights a patient-centered guide on provision of safe fertility treatment across the Asia-Pacific region, which can be adapted to suit country-specific requirements depending on the stage of the pandemic, local restrictions, and availability of resources.

The interdisciplinary team experiences of managing patient safety during a fixed-wing inter-hospital aeromedical transport: A qualitative study

• Some situations in aeromedical transport are unexpected; • Team experience and skills contribute to patient safety; • Training and checklists minimize risks; • Difficulties in transport are often due to environmental human and flight condition.

Effect of Patient Safety Competency on Patient Safety Management Activities in Perianesthesia Nurse

본 연구는 회복마취간호사의 환자안전역량이 환자안전관리활동에 미치는 영향을 파악하기 위해 시도되었다. 연구방법은 2020년 9월 12일 회복마취간호사회 비대면 워크숍에 참여자 중 연구목적과 방법을 듣고 동의한 135명을 대상으로 구조화된 설문지를 이용하여 자료를 수집한 서술적 조사연구이다. 자료 분석은 기술통계량과 회귀분석을 이용하였다. 연구 결과 환자안전역량은 총 4.19점이었으며 하부영역의 지식은 4.11점, 기술 4.20점, 태도 4.26점이었다. 환자안전 지식은 연령, 교육 정도, 임상경력, 현 부서경력, 환자 안전교육 경험, 안전업무담당 경험에서, 환자안전기술은 연령, 임상경력, 현 부서경력, 안전업무담당 경험에서, 환자안전 태도는 연령, 임상경력, 현 부서경력에서 유의한 차이가 있었다. 환자안전관리활동은 환자안전 지식(r=.349, p<.001), 기술(r=.464, p<.001), 태도(r=.380, p<.001)와 유의한 상관관계가 있었다. 안전관리활동에 영향을 미치는 요인은 환자안전 기술(β=.29, p=.021), 환자안전 태도(β=.22, p=.025)이었으며 설명력은 22.9%이었다. 회복마취간호사의 환자안전역량 향상을 위해 회복마취간호사가 갖추어야 할 환자안전술기를 포함한 실무중심의 교육프로그램 개발과 지속적인 적용으로 마취환자의 안전사고 예방을 도모해야 한다.

Using Failure Mode, Effect and Criticality Analysis to Improve Safety in the COVID Mass Vaccination Campaign.

Vaccination against SARS-CoV-2 will likely be the most promising way to combat the pandemic. Even if mass vaccination is urgent, it should still always be supported by appropriate patient safety management. The aim of this study, based on failure mode, effects and criticality analysis (FMECA), was to identify possible failures and highlight measures that can be adopted to prevent their occurrence. A team of resident doctors in public health from the University of Padua and specialists in risk analysis in public health examined the mass vaccination process. A diagram was drafted to illustrate the various phases of mass vaccination, analyze the process, and identify all failure modes. Criticalities were ascertained by rating the severity, frequency and likelihood of failure detection on a scale of 1 to 10. We identified a total of 71 possible faults distributed over the various phases of the process, and 34 of them were classified as carrying a high risk. For the potentially high-risk failure modes, we identified 63 recommended actions to contain the cause of their occurrence or improve their detection. For the purpose of detecting potential failures, FMECA can be successfully applied to mass vaccination, which should be considered a high-risk process.

Tisagenlecleucel Therapy: Nursing Considerations for the Outpatient Setting.

Tisagenlecleucel is a CD19-directed, genetically modified, autologous T-cell immunotherapy indicated for pediatric and young adult patients with relapsed/refractory B-cell precursor acute lymphoblastic leukemia and for adult patients with relapsed/refractory diffuse large B-cell lymphoma. Treatment with any chimeric antigen receptor (CAR)-T cell therapy is a multistep process in which nurses and nurse practitioners are key to managing patient safety. Managing patients receiving CAR-T cell therapy in the outpatient setting (as Penn does with tisagenlecleucel and lisocabtagene maraleucel) requires an even more complex process. The objective of this manuscript is to provide guidance on the role of nurses in the outpatient administration of tisagenlecleucel therapy and postinfusion care in adult patients with diffuse large B-cell lymphoma. Oncology and apheresis nurses discuss institutional processes and perspectives related to the patient experience with tisagenlecleucel therapy at the Hospital of the University of Pennsylvania. Author experience. Nurses are vital for the success of the patient management processes involved with tisagenlecleucel therapy. Nurses must be thoroughly educated in tisagenlecleucel therapy and adverse event management and be able to effectively communicate all aspects of therapy among the multidisciplinary team of the hospital, the product manufacturer, and patients and families. Establishment of the nurse cellular therapy coordinator at the Hospital of the University of Pennsylvania was advantageous in facilitating effective communication in all these situations. This encompassing approach to patient management is particularly necessary during administration of tisagenlecleucel therapy and other CAR-T cell therapies that are managed in the outpatient setting.

Patient safety management systems and activities related to promoting voluntary in-hospital reporting and mandatory national-level reporting for patient safety issues: A cross-sectional study.

Both voluntary in-hospital reporting and mandatory national-level reporting systems for patient safety issues need to work well to develop a patient safety learning system that is effective in preventing the recurrence of adverse events. Some of the hospital systems and activities may increase voluntary in-hospital reporting and mandatory national-level reporting. This study aimed to identify the hospital systems and activities that increase voluntary in-hospital reporting and mandatory national-level reporting for patient safety issues. An anonymous mail survey of hospitals in Japan was conducted in 2017. The hospitals were selected by stratified random sampling according to number of beds. The survey examined the annual number of reported events in the voluntary in-hospital reporting system for patient safety and experience of reporting unexpected patient deaths possibly due to medical interventions to the mandatory national-level reporting system in the last 2 years. The relationship of the answer to the questions with the patient safety management systems and activities at each hospital was analyzed. The response rate was 18.8% (603/3,215). The number of in-hospital reports per bed was positively related to identifying events by referring complaints or questions of patients or family members, using root cause analysis for analyzing reported events, and developing manuals or case studies based on reported events, and negatively related to the unification and standardization of medical devices and equipment. The experience with mandatory national-level reporting of serious adverse events was positively related to identifying problematic cases by a person in charge of patient safety management from the in-hospital reporting system of complications and accidental symptoms. Enhanced feedback for reporters may promote voluntary in-hospital reporting of minor cases with low litigation risks. Developing an in-hospital mechanism that examines all serious complications and accidental symptoms may promote mandatory national-level reporting of serious adverse events with high litigation risks.

Implementation of six patient safety goals at a public health centre with in-patient services in Bali, Indonesia: A qualitative case study

Background and purpose: The Indonesian government requires all health care facilities including public health centres (PHCs) to implement a patient safety program as part of the accreditation standard process. The implementation of patient safety in PHCs have faced various problems, including human resources and infrastructure issues. This study aims to explore the implementation of patient safety target procedures in an accredited inpatient PHC in Tabanan District, Bali, Indonesia.Methods: We conducted a qualitative case study that adopts four main domains in patient safety, consisting of executive officers, community or patient who received services, systems in service delivery and methods, and elements in each domain. The research location was at Penebel I PHC, an inpatient PHC with the accreditation status of “utama”. Data collection was carried out from March to April 2020. It includes observation of the patient safety implementation, review on tracking patient safety documents and in-depth interviews with 11 informants who are PHC staff, patients’ safety task force and the family of patients. The data were analysed using thematic analysis by creating a grid of themes, sub-themes and data reduction to narrative presentation.Results: The patient safety procedure in Penebel I PHC has been carried out through the standard and procedure according to the Ministry of Health (MoH) regulation which consist of patient identification; communication between staff and patients; maintain the safety of High Alert and Look Alike Sound Alike (LASA) medications. However, there is a need to improve the capacity of implementing officers to increase their communication competencies as well as to enhance cooperation between officers in health services to avoid patient safety incidents.Conclusion: The implementation of six patient safety goals in-corporate through four main domains of health care services has been running according to the MoH’s standard. There is a need to improve the competence of officers, cooperation between officers in carrying out patient safety management and improve communication between officers and patients so that the information conveyed by officers is truly understood by patients.

A Comparison of the Clinical Competence, Knowledge of Patient Safety Management and Confidence of Patient Safety Management according to Clinical Practice Experience of Nursing Students

A Comparison of the Clinical Competence, Knowledge of Patient Safety Management and Confidence of Patient Safety Management according to Clinical Practice Experience of Nursing Students

Assess the nurses perception of patient safety culture and safety control in patient safety management activities

Assess the nurses perception of patient safety culture and safety control in patient safety management activities