Patient Safety Management Research Articles

Prospective systematic risk analysis of the digital technology use within pharmaceutical care

BackgroundDigital technologies are present in every phase of a drug lifecycle, from drug design and development to its dispensing and use. However, given the rapid development and implementation of digital solutions, their monitoring, evaluation, and risk assessment are limited and lacking. ObjectiveThis research is aiming to identify potential errors, quantify and prioritize associated risks in the context of certain technologies used in pharmaceutical care, as well as define corrective measures to improve patient safety and the quality of pharmaceutical care. MethodsA 10-member multidisciplinary team conducted Failure Mode and Effect Analysis (FMEA) to identify critical risks, their causes and effects, along with developing corrective measures within the selected digital health components: Telepharmacy, mHealth, Artificial intelligence (AI), and Software infrastructure and systems. Critical risks were determined by calculating risk priority numbers (RPNs) from severity, occurence, and detectability scores. ResultsThis study identified 42 risks regarding the 4 components. After calculating RPNs and the threshold RPN (RPN=30), 8 critical risks were identified. Corrective measures were proposed for these failure modes, after which the risks were re-evaluated (RPN sum was reduced from 414 to 156). The risk with the highest RPN value was Internet/identity fraud, while the rest included inadequate and incomplete data entry and management, flawed implementation, human and technology errors, and lack of transparency, personalization and infrastructure. For the critical risks, 42 different causes were recognized on a system, technological and individual level while their effects were discussed in terms of patient safety and business management in pharmacies. ConclusionDigitalization of pharmaceutical practice promises greater effectiveness of pharmaceutical care, but in order to achieve this, efforts, resources and initiatives must be directed toward timely identification of problems, appropriate monitoring, and building adequate infrastructure that can support safe implementation of digital tools and services despite the swift development of innovations.

TeamSTEPPS improves patient safety

BackgroundExamine how Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) can be used to manage patient safety and improve the standard of care for patients.MethodsIn order to...

Visual Analysis of Research Hotspots on Near Miss in the Nursing Field

Objective To analyze the current research status, hot spots and dynamic frontiers of literature related to near misses in nursing using visual knowledge mapping, in order to provide a reference for the future development of near misses in nursing. Methods The literature related to near misses in nursing was searched in the Web of Science core collection from its establishment to August 2022, and visualized and analyzed in terms of the number of articles, journals and keywords. Results A total of 289 papers were included, and the annual publication volume showed a trend of year-on-year growth, with the United States taking the first place in terms of publication volume and the initial formation of a core author team, and the hotspots of proximity research in the nursing field were mainly focused on patient safety, safety management, and identification reporting. Conclusion The research related to proximity errors in nursing started late, and the current research on proximity errors is not comprehensive enough. Since the occurrence of proximity errors can have adverse effects on patients, nursing staff and medical institutions, it is suggested that nursing managers should increase the importance of this issue, pay attention to the frontier development, and conduct in-depth related research.

Model Patient Safety Management Activities for Nursing Students with Clinical Experience

Model Patient Safety Management Activities for Nursing Students with Clinical Experience

Barriers to implementing patient safety incident reporting and learning guidelines in specialised care units, KwaZulu-Natal: A qualitative study.

Globally, increased occurrences of patient safety incidents have become a public concern. The implementation of Patient safety incidents reporting and learning guidelines is fundamental to reducing preventable patient harm. To improve the implementation of these guidelines in specialised care units in KwaZulu-Natal, the views of healthcare professionals were unearthed. This study explores the healthcare professionals' views toward the implementation of Patient safety incident reporting and learning guidelines in specialised care units. A descriptive, explorative qualitative approach was used to collect qualitative data from healthcare professionals working in specialised care units. The study was conducted in specialised care units of three purposely selected public hospitals in two districts of KwaZulu-Natal. Group discussions and semi-structured interviews were conducted from August to October 2021. Content data analysis was performed using Tesch's method of analysis process. The main themes that emerged during data analysis were; ineffective reporting system affecting the communication of Patient safety incident guidelines, inadequate institutional and management support for the healthcare professionals, insufficient education and training of healthcare professionals, and poor human resources affecting the implementation of Patient Safety Incident guidelines. The findings highlighted that there were more major barriers to the implementation of the Patient safety incident reporting and learning guidelines. This study confirmed that the Patient safety incident reporting and learning guidelines are still not successfully implemented in the specialised care units and the barriers to implementation were highlighted. For rigorous implementation in South Africa, the study recommends revised Patient safety incident reporting and learning guidelines, designed in consultation with the frontline healthcare professionals. These must consist of standardised, simple- user-friendly reporting process as well as a better implementation strategy to guide the healthcare professionals. Continuous professional development programmes may play an important role in the facilitation of the implementation process.

Attitude towards the risk-based approach implementation into the russian healthcare system among employees of medical organizations

Aim of the study was to develop recommendations for improving procedures and unifying the content of risk management of the healthcare system to preserve public health based on an analysis of the opinions of doctors, organizers and experts of the healthcare system. Material and methods. As part of a quantitative online survey conducted from September to December, 2022, 104 respondents working in the healthcare system of the Russian Federation were interviewed. Additionally, 6 in-depth interviews were conducted with the organizers and experts of the healthcare sector as part of a qualitative sociological study. Desk research included analysis of scientific literature, and the regulatory framework related to the introduction of a risk-based approach to healthcare. Results and discussion. The article presents an analysis the perception of risks in healthcare by doctors, organizers and experts at the level of a medical organization, of the healthcare system and of public health (macro level), with the identification and classification of the main risk groups, on the basis of which risk-management’ measures can be built. The results of the study testify to the insufficiently deep introduction of risk management into the management system of medical organizations. The half of the respondents noted the low and extremely low level of risk management principles’ usage in their own organizations (50 % of respondents) and in Russian medical organizations in general (58.6 % of respondents). At the same time, from a third to a half of the participants found that it was difficult to answer about risk management implementation in their organizations, due to the lack of a unified methodology, imperfection of standards and quality control system of this set of measures, lack of specialists who could manage risks, lack of educational activities. To introduce a systematic approach to the unification of risk management processes, it is necessary to develop and approve the methodology of best practices, as well as take care of the training of specialists. Conclusions. In order to implement a systematic approach to the unification of risk management processes, it is necessary to develop and approve a methodology of best practices, as well as to take care of the training of specialists. It is imperative that hospital managers and staff focus on improving the organizational culture of patient safety management as the basis for their mission to preserve public health. It is necessary to continue further research in this direction in order to develop a strategy for countering risks at the level of public health as a medical and social resource of society.

Exploring the influencing factors of patient safety competency of clinical nurses: a cross-sectional study based on latent profile analysis

BackgroundClinical nurses play an important role in ensuring patient safety. Nurses’ work experience, organizational environment, psychological cognition, and behavior can all lead to patient safety issues. Improving nurses’ attention to patient safety issues and enhancing their competence in dealing with complex medical safety issues can help avoid preventable nursing adverse events. Therefore, it is necessary to actively identify the latent profiles of patient safety competency of clinical nurses and to explore the influencing factors.MethodsA cross-sectional design was conducted. A total of 782 Chinese registered nurses were included in the study. Demographic characteristics questionnaire, Error Management Climate scale, Security Questionnaire, Proactive Behavior Performance scale and Patient Safety Competency Self-Rating Scale of Nurses were used. Latent profile analysis (LPA) was performed to categorize nurses into latent subgroups with patient safety competency differences. Multinomial logistic regression was conducted to explore the influencing factors of nurses’ patient safety competency (PSC) in different latent profiles.ResultsA total of 782 questionnaires were valid. Nurses’ PSC was positively related to error management climate, and psychological safety and proactive behavior. The PSC score was 121.31 (SD = 19.51), showing that the PSC of clinical nurses was at the level of the medium on the high side. The error management climate score was 70.28 (SD = 11.93), which was at a relatively high level. The psychological safety score was 61.21 (SD = 13.44), indicating a moderate to low level. The proactive behavior score was 37.60 (SD = 7.33), which was at a high level. The latent profile analysis result showed that three groups of profile models were fitted acceding to the evaluation of PSC. They were defined as Low-competency Group (74 (9.5%)), Medium-competency Group (378 (48.3%)) and High-competency Group (330 (42.2%). Working years, professional titles, departments, error management climate, psychological security and proactive behavior were the influencing factors of PSC in three latent profiles.ConclusionsThe PSC of clinical nurses had obvious classification characteristics, and the main influencing factors were working years, professional titles, working departments, error management climate, psychological security and proactive behavior. This study suggests that managers should pay attention to the continuous cultivation of patient safety competence among clinical nurses, provide targeted intervention measures for nurses at different work stages, professional titles, and departments, and use efficient management strategies to create a positive error management atmosphere. In patient safety management, providing nurses with more psychological security is conducive to stimulating more proactive behaviors and continuously improving the level of patient safety competence.

The factors influencing patient safety management as perceived by emergency department nurses: A qualitative study.

One of the most important, unpredictable and stressful areas in hospitals is the emergency department (ED) where seconds are crucial for providing immediate care and saving the patients' lives. Therefore, the present study aimed to identify the factors which impact the patient safety management as perceived by the ED nurses in Southern Iran. This is a qualitative, descriptive study. The participants were 23 ED nurses selected via purposeful sampling who were asked to take part in an interview. Data were collected using semi-structured, individual, in-depth interviews and analysed via content analysis. Analysis of the qualitative data yielded 4 themes and 12 subthemes. The four main themes were: negligence of safety standards and standard precautions, disregard of ethical principles, professional challenges and inefficient organizational management.

Effects of perceptions of the importance of patient safety management and patient safety competency on patient safety management activities among nurses at unaccredited general hospitals

Purpose: This descriptive research study attempted to determine how general hospital nurses’ awareness of the importance of patient safety management and patient safety competency affected patient safety management activities.Methods: From September 13 to 26, 2022, a survey was administered to 230 ward nurses who provided direct care to patients at five non-accredited general hospitals being evaluated for accreditation located in metropolitan cities. The collected data were analyzed with descriptive statistics, the t-test, one-way analysis, the Scheffé test, Pearson correlation coefficients, and hierarchical regression using SPSS for Windows version 26.0.Results: In total, 221 (96.1%) respondents were female. The average age was 32.2 years, and the average clinical experience was 3.5 years; 196 participants (85.2%) were general nurses. Patient safety competency (β = .44, p < .001), awareness of the importance of safety management (β = .31, p < .001), and medication error experience (β = -.15, p = .002) all had statistically significant associations with patient safety management activities. The explanatory power of these variables for patient safety management activities was 50.7%. Conclusion: This study confirmed that patient safety competency, awareness of the importance of patient safety management, and experience with medication errors significantly influenced patient safety management activities.

Artificial Intelligence Assistive Software Tool for Automated Detection and Quantification of Amyloid-Related Imaging Abnormalities

Amyloid-related imaging abnormalities (ARIA) are brain magnetic resonance imaging (MRI) findings associated with the use of amyloid-β-directed monoclonal antibody therapies in Alzheimer disease (AD). ARIA monitoring is important to inform treatment dosing decisions and might be improved through assistive software. To assess the clinical performance of an artificial intelligence (AI)-based software tool for assisting radiological interpretation of brain MRI scans in patients monitored for ARIA. This diagnostic study used a multiple-reader multiple-case design to evaluate the diagnostic performance of radiologists assisted by the software vs unassisted. The study enrolled 16 US Board of Radiology-certified radiologists to perform radiological reading with (assisted) and without the software (unassisted). The study encompassed 199 retrospective cases, where each case consisted of a predosing baseline and a postdosing follow-up MRI of patients from aducanumab clinical trials PRIME, EMERGE, and ENGAGE. Statistical analysis was performed from April to July 2023. Use of icobrain aria, an AI-based assistive software for ARIA detection and quantification. Coprimary end points were the difference in diagnostic accuracy between assisted and unassisted detection of ARIA-E (edema and/or sulcal effusion) and ARIA-H (microhemorrhage and/or superficial siderosis) independently, assessed with the area under the receiver operating characteristic curve (AUC). Among the 199 participants included in this study of radiological reading performance, mean (SD) age was 70.4 (7.2) years; 105 (52.8%) were female; 23 (11.6%) were Asian, 1 (0.5%) was Black, 157 (78.9%) were White, and 18 (9.0%) were other or unreported race and ethnicity. Among the 16 radiological readers included, 2 were specialized neuroradiologists (12.5%), 11 were male individuals (68.8%), 7 were individuals working in academic hospitals (43.8%), and they had a mean (SD) of 9.5 (5.1) years of experience. Radiologists assisted by the software were significantly superior in detecting ARIA than unassisted radiologists, with a mean assisted AUC of 0.87 (95% CI, 0.84-0.91) for ARIA-E detection (AUC improvement of 0.05 [95% CI, 0.02-0.08]; P = .001]) and 0.83 (95% CI, 0.78-0.87) for ARIA-H detection (AUC improvement of 0.04 [95% CI, 0.02-0.07]; P = .001). Sensitivity was significantly higher in assisted reading compared with unassisted reading (87% vs 71% for ARIA-E detection; 79% vs 69% for ARIA-H detection), while specificity remained above 80% for the detection of both ARIA types. This diagnostic study found that radiological reading performance for ARIA detection and diagnosis was significantly better when using the AI-based assistive software. Hence, the software has the potential to be a clinically important tool to improve safety monitoring and management of patients with AD treated with amyloid-β-directed monoclonal antibody therapies.

Managing patient safety and staff safety in nursing homes: exploring how leaders of nursing homes negotiate their dual responsibilities-a case study.

Within healthcare, the role of leader is becoming more complex, and healthcare leaders carry an increasing responsibility for the performance of employees, the experience and safety of patients and the quality of care provision. This study aimed to explore how leaders of nursing homes manage the dual responsibility of both Health, Safety and Environment (HSE) and Quality and Patient Safety (QPS), focusing particularly on the approaches leaders take and the dilemmas they face. In addition, we wanted to examine how leaders experience and manage the challenges of HSE and QPS in a holistic way. The study was designed as a case study. Data were collected through semi structured individual interviews with leaders of nursing homes in five Norwegian municipalities. 13 leaders of nursing homes in urban and rural municipalities participated in this study. Data analysis resulted in four themes explaining how leaders of nursing homes manage the dual responsibility of HSE and QPS, and the approaches they take and the dilemmas they face: 1.Establishing good systems and building a culture for a work environment that promotes health and patient safety.2.Establish channels for internal and external collaboration and communication.3.Establish room for maneuver to exercise leadership.4.Recognizing and having the mandate to handle possible tensions in the dual responsibility of HSE and QPS. The study showed that leaders of nursing homes who are responsible for ensuring quality and safety for both patients and staff, experience tensions in handling this dual responsibility. They acknowledged the importance of having time to be present as a leader, to have robust systems to maintain HSE and QPS, and that conflicting aspects of legislation are an everyday challenge.

Cone-beam computed tomography in implant dentistry - guidelines, current concepts and limitations for practice

This article issues scientific background of Cone-beam computed tomography (CBCT) and the importance of taking x-rays before and after implant placement in daily practice as a common care. The review will introduce cone-beam computed tomography guidelines, restrictions and intraoperartive issues for instance nerve damage and bleeding incidents. Modern CBCT technology enables specialists to avoid making a wrong diagnosis, which translates into a higher percentage of people with a positive treatment outcome.
 Diagnostic radiology is a crucial element of every dental treatment planning. CBCT market is expanding gradually since two decades, there are more than 85 distinct CBCT tools available. CBCT is a three-dimensional (3D) imaging used nowadays in dentistry with increased frequency and offers volumetric data on jaw bones and teeth with relatively low radiation doses and costs. Currently, the greatest advantage of CBCT examinations over radiographs is the fact that the image obtained is presented in a 3D projection and not, as is the case, in 2D. It has the ability to help a wider range of patients, but the use of CBCT also has negative consequences. Routine or excessive use has resulted in increased radiation doses accumulating in the patient's body, which translates into an increased risk of adverse effects. The risk varies according to the age of the patient under study and is directly proportional to it, that is, it is highest for young people and lower for older people. The potential risk is also slightly higher in the female population. For this reason, creating awareness of the mandatory patient safety management of CT scans is a key process by which X-ray exposures can be optimised.

Design and innovation of a utility model patent for tracheal cannula fixation belt

Tracheostomy is a very common airway procedure in the treatment of critically ill neurological patients. At present, the traditional tracheal cannula fixation belt is easy to be contaminated, difficult to disinfect, and needs to be replaced regularly. It is prone to infection, skin injury, unplanned extubation and other adverse events, which cannot meet the clinical treatment effect and patient safety management. In order to overcome the above problems, the medical staff of the neurology intensive care unit of Henan Provincial People's Hospital designed a new type of tracheal cannula fixation belt to increase patient comfort and reduce complications, and obtained a National Utility Model Patent of China (ZL 2022 2 0855188.8). The main structure of the device includes a following shaped bending plate, a fastening belt, a locking pin, and a distance adjustment hole. The left and right sides of the shaped bending plate are equipped with fastening belts with breathable and anti-wear pads. The inner side of the left fastening belt is equipped with two sets of locking pins, and the outer surface of the right fastening belt and breathable and anti-wear pad is equipped with multiple sets of distance adjustment holes. Additionally, the back of the shaped bending plate is equipped with breathable buffer pads. The fastening belt can drive the following bending plate to stick tightly to the patient's neck. The operator installs the locking pin card into the distance adjustment hole according to the "one back" principle, and the fastening belts on both sides fix the device with the cooperation of the locking pin, greatly reducing the probability of excessive displacement of the tracheal tube during use, effectively improving the fixation effect of the device, strengthening the adaptability of the device to different personnel, and thus enhancing the practicality of the device. The new type of tracheal cannula fixation band is convenient, safe and efficient, which can increase patient comfort, reduce complications. It has certain clinical value and is suitable for clinical promotion.

Effects of Patient Safety Management System, Leadership, and Communication Types on Nurse’ Patient Safety Management Activities

Effects of Patient Safety Management System, Leadership, and Communication Types on Nurse’ Patient Safety Management Activities

Assessing Patient Safety Culture among Hospital Nurses in Mosul: A Comprehensive Survey

Background: Patient safety culture stems from the collective and individual values, attitudes, perceptions, skills, and behaviors that shape health providers' commitment, approach, and effectiveness in managing safety. Objective: This study aimed to evaluate the patient safety culture among nurses in various healthcare settings, examining demographic characteristics and perceptions across domains including teamwork, leadership, communication, reporting, and hospital management. Methods: A comprehensive cross-sectional survey was meticulously conducted with 130 nurses from different hospitals. The participants provided detailed demographic information, and their responses to a Patient Safety Culture Survey, which covered five domains: unit/Work Area, Supervisor/Manager/Clinical Leader, Communication, Reporting Patient Safety Events, and Hospital Management, were thoroughly analysed. Results: The study revealed several key findings that can improve patient safety culture. Notably, at the same time, people generally hold positive views about how healthy teams work together; they express concerns about not having enough staff and relying too much on temporary workers. There are also concerns about mistreatment. The Leaders' approach to managing and communicating indicates a need to carefully balance efficiency with patient safety. The culture of reporting problems is somewhat inclined, with people reporting issues at varying frequency levels. When it comes to how well the hospital is run, people have mixed feelings about the management's commitment, the resources provided, and the coordination among different parts of the hospital. Conclusion: The findings of this study, with their profound implications for the fields of patient safety and healthcare management, not only highlight the intricate dynamics within healthcare units but also identify specific areas where targeted interventions can significantly improve the patient safety culture. The critical steps to creating safer healthcare environments, including addressing staffing challenges, nurturing supportive leadership, enhancing communication, and promoting a strong reporting culture, present a roadmap for positive change. The potential for improvement in the patient safety culture is not only a possibility but a tangible goal that can be achieved with the right interventions and strategies. This potential for improvement should inspire healthcare professionals, researchers, and policymakers to take action and work towards a safer healthcare environment.

Designing and Validating an Evidence-Based, Shift-to-Shift Handover Bundle for Nurses and Physicians.

This article reports a study aimed at developing and validating an evidence-based, shift-to-shift handover bundle for nurses and physicians to be used at shift changes in intensive care and emergency units. Deficient or absent clinical handovers, or failures to transfer information, responsibility, and accountability can have unwanted consequences for hospitalized patients, particularly those at critical areas. Clinical handovers are practiced every day, in many ways, in all institutional health care settings. Despite increasing demand for structured processes to guide clinical handovers, standardized handover bundles for nurses and physicians are limited in the emergency and intensive care unit. As a result of this study, a shift-to-shift handover bundle was created, which was an evidence-based research design. This bundle is expected to be helpful for proper patient transfers between these critical areas, ensuring patient safety and efficient quality management.

Developing an Operating Room-to-Intensive Care Unit Patient Handover Checklist: A Combined Quantitative and Qualitative Research Design.

This article reports a study aimed at developing and validating an Operating Room-to-ICU Patient Handover checklist. Deficient or absent clinical handovers, or failures to transfer information, responsibility, and accountability can have unwanted consequences for hospitalized patients. Clinical handovers are practiced every day, in many ways, in all institutional health care settings. Despite increasing demand for structured processes to guide clinical handovers, standardized handover bundles for nurses and physicians are limited in the intensive care unit. As a result of this study an Operating Room-to-ICU Patient Handover checklist was created, which was based on a quantitative and qualitative research design. This checklist is expected to be helpful for proper patient transfers between these critical areas, ensuring patient safety and efficient quality management.

Effects of Nurse-Nurse Collaboration and Nurse-Physician Collaboration on Nursing Performance in Nurses: The Mediating Effect of Patient Safety Management Activities

Effects of Nurse-Nurse Collaboration and Nurse-Physician Collaboration on Nursing Performance in Nurses: The Mediating Effect of Patient Safety Management Activities

Exploring The Responsibilities Of Emergency Nurse In Patient Safety: Systematic Review And Meta-Analysis

Background: Patient safety is a critical component of nursing care, particularly in emergency services, where nurses must manage complex, high-stakes situations that require rapid decision-making and intervention. The role of emergency room nurses is multifaceted, encompassing patient reception, initial assessment, care implementation, follow-up, and discharge planning. Given the unpredictable nature of emergency care, effectively managing patient safety is paramount.

Validation of a training model of professional competence management of patient safety in intensive care in the Bachelor of Nursing degree

Introduction: the pedagogical model as a scientific result of educational research, understood as a representation of essential elements of the training process or some of its parts. Objective: to validate a model for the formation of the professional competence “Management of patient safety in intensive care” in the Bachelor’s degree in Nursing. Method: a study was carried out at the Baracoa Medical Sciences Branch, belonging to the Guantánamo University of Medical Sciences from 2016-2018, methods such as methodological triangulation were used through the criteria of 20 experts by the Green method. Results: the consensus general of the experts was “strongly in agreement” for the foundations that support the training model of professional competence “Management of patient safety in intensive care” in the Nursing Bachelor’s degree and its quality. Conclusions: the training model of professional competence “Management of patient safety in intensive care” is accepted as valid and feasible for its implementation in practice, it constitutes a novel and relevant contribution for the transformation of the training process in the career of Nursing, from the Emergency Nursing subject in the fourth year, which promotes the relationship between the systematization of skills and the development of innovation capacity in students to guarantee patient safety