Patient Safety Measures Research Articles

Integrated health information system in the Republic of Serbia

The Republic of Serbia's integrated health information system (IHIS) serves as a central electronic repository for storing and processing various medical and health-related data. It encompasses patient records, institutional information, details of health interventions and services, electronic prescriptions, appointment scheduling for specialist consultations, diagnostic procedures, and surgical operations. The implementation of this system promises several benefits, including improved access to patient information, expedited diagnostics, enhanced medication selection processes, heightened patient safety measures, more comprehensive health-statistical reporting, and accelerated dissemination of biomedical knowledge. This paper aims to explore the advantages of employing information technologies in healthcare delivery within health institutions, contrasting it with traditional methods of data collection, analysis, and interpretation, specifically focusing on primary healthcare institutions. Drawing upon current professional and societal perspectives, the paper discusses the conceptual framework and objectives of IHIS, emphasizing the significance of leveraging information technologies in healthcare.

The Attitudes of Emergency Department Nurses towards Patient Safety in Alqassim Region, Saudi Arabia: A Questionnairebased Cross-sectional Study

Introduction: Patient safety is a crucial aspect of healthcare delivery, and nurses play a critical role in ensuring that patients receive safe and high-quality care. As healthcare systems continue to evolve, it is essential to understand the attitudes and perceptions of nurses towards patient safety. Aim: To explore emergency department nurses’ attitudes toward patient safety in the Alqassim region, Saudi Arabia. Materials and Methods: This was a cross-sectional study involving 420 emergency department nurses from the hospitals of the Alqassim region, Saudi Arabia. The World Health Organisation (WHO) patient safety questionnaire, specifically tailored for nurses, was employed. Data analysis was conducted using Statistical Package for Social Sciences (SPSS) version 25.0. Results: Total of 139 nurses out 420 completed the research. Most participants were males aged between 22 and 30 years, married, and held a Bachelor of Science in Nursing (BSN) degree. The overall average score for patient safety reached a moderate level, with a mean of 118.66±23.33. The component on workplace safety had the highest average score of 32.33±7.40, while the section on personal attitudes towards patient safety had the lowest average score of 15.02±3.72. Conclusion: Nurses exhibited moderate attitudes towards various aspects of patient safety, including error and patient safety, healthcare system safety, and personal attitudes towards patient safety. Enhancing patient safety measures is crucial for fostering a resilient safety culture in the healthcare sector.

The Implementation Of Patient Safety Management In Melati General Hospital, Perbaungan

This study examines the implementation of patient safety management at Melati General Hospital in Perbaungan. Patient safety is a critical component of healthcare quality, aimed at minimizing risks, errors, and harm to patients during the provision of health services. The research utilizes a qualitative approach, involving comprehensive interviews with hospital staff, direct observations, and analysis of hospital safety protocols and records. Key findings reveal that while Melati General Hospital has established several patient safety measures, there are areas needing improvement, particularly in staff training, adherence to safety protocols, and incident reporting systems. The study identifies the strengths and weaknesses of the current patient safety management practices and offers recommendations for enhancing the safety culture within the hospital. Effective implementation of these recommendations is expected to lead to significant improvements in patient safety outcomes, thereby ensuring higher standards of care and patient trust.

Văn hoá an toàn người bệnh và một số yếu tố ảnh hưởng tại Bệnh viện Phạm Ngọc Thạch, Thành phố Hồ Chí Minh năm 2023

Objective: To measure patient safety culture and some factors influence in 12 areas relating to patient care in Pham Ngoc Thach Hospital. Methods: Cross-sectional research. The Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire of the Agency of Healthcare Research and Quality (AHRQ) version Vietnamese was used in this survey. All medical staff working in the Pham Ngoc Thach Hospital were asked to complete the questionnaire. We employed the software Stata 16.0 and Microsoft Excel 2010 to perform the statistical analysis of the survey data. Average positive response rate in 12 patient safety culture dimensions in Pham Ngoc Thach Hospital was 75%, higher than in Taiwan (64%). Worthy of note were the high positive response rates observed in the following areas: Teamwork within units (94%), manager views and actions promoting patient safety (91%), management support for patient safety, learning-continuous improvement (89%), and feedback and communication about errors (85,6%). However, there were three areas that still received many negative responses and showed room for improvement such as handoff, transitions, staffing, and non-punitive response to errors. The survey in Pham Ngoc Thach Hospital which provides an overview of the patient safety culture in the hospital. Although most medical staff had positive responses regarding patient safety in many areas relating to patient care within their departments as well as in the whole hospital, but there were still areas that had a low positive response and needed to be improved.

Lessons to enhance integrated care by assessing between-hospital variation in mortality, readmissions and prolonged length-of-stay for cardiovascular diagnoses: results of a cardiovascular population analysis.

Background: Unwarranted between-hospital variation is a persistent healthcare quality issue that can threaten healthcare equity. Despite the benefits of studying multiple patient outcomes together, research on between-hospital variation has often focused on single outcomes or disease-specific study populations. In this study we examined three important patient outcomes: (1) in-hospital mortality as a pinnacle measure of patient safety; (2) 30-day readmissions as an accountability measure for hospitals; and (3) prolonged length-of-stay, i.e. a length-of-stay above the All-Patient-Refined Diagnoses-Related-Group (APR-DRG)-specific 90th percentile (pLOS) because of its correlations with complications and costs of care. By tapping into the potential of administrative discharge datasets, that today are primarily used for financial purposes, we aimed to quantify between-hospital variation, allowing for priority setting for future quality improvement policies. As the level of between-hospital variation is unknown for cardiology patients, we set out to study a nationwide cardiology sample.
 Who is it for: This study is highly relevant for both clinicians and policymakers on hospital and governmental level.
 Methods: In this observational study, we used hierarchical mixed-effects logistic regression models to estimate hospital- and APR-DRG-specific risk-standardised rates. Between-hospital variation was assessed based on the estimated variance components. We studied 521,162 hospital admissions for cardiovascular pathologies, divided into 28 APR-DRGs, in 99 (98%) Belgian acute-care hospitals between 2016 and 2018.
 Findings: Our analysis revealed notable between-hospital variation in mortality, readmission and prolonged length-of-stay for cardiovascular hospital admissions in Belgium, in particular for medical diagnoses. Seven medical diagnoses were found to have significant between-hospital variation across the three studied outcomes, among which heart failure, angina pectoris and hypertension. Lowering of mortality rates in upper-quartile hospitals to the median could potentially annually save 633 cardiovascular deaths or 26.4% of deaths occurring in these hospitals. Moreover, an overall prevention of 322 (11.8%) readmissions and 1578 (33.3%) long patient stays could be secured in those bottom-performing hospitals. The largest absolute gain could be made for heart failure patients with 122 deaths, 62 readmissions and 277 pLOS potentially avoided.
 Interpretation: Our results are suggestive of larger inequalities in cardiovascular quality of care for medical than for surgical admissions. We would recommend future policies to target these diagnoses. Further investments and implementation of clinical guidelines and standardisation as well as systematic collation and benchmarking of outcomes and variation on national and international levels have proven valuable to ensure future focus on the right priorities. As we will demonstrate during this presentation, administrative data are useful for this longitudinal follow-up, as they require no additional workload, are readily available and reliable when applying adequate statistical modelling. Our findings have demonstrated that reducing variation in patient outcomes could be highly beneficial, at least for the cardiovascular patient population. The methods presented are easily transferrable to other disease groups besides cardiology, allowing for quality priority setting across the healthcare spectrum. 

Population analysis of temporal trends and between-hospital variation in mortality, readmission and prolonged length-of-stay between 2008 and 2018: improving integrated care by knowledge sharing of hospitals’ care progress

Background: Despite the benefits of studying multiple patient outcomes together, research on between-hospital variation has often focused on single outcomes or disease-specific study populations. In the study we would like to present, we examined nationwide temporal trends and between-hospital variation in three important patient outcomes: (1) in-hospital mortality as a pinnacle measure of patient safety; (2) 30-day readmissions as an accountability measure for hospitals; and (3) prolonged length-of-stay, i.e. a length-of-stay above the All-Patient-Refined Diagnoses-Related-Group (APR-DRG)-specific 90th percentile (pLOS) because of its correlations with complications and costs of care.
 Who is it for: This study is highly relevant for both clinicians and policymakers on hospital and governmental level. 
 Methods: In this observational study, we made use of a large administrative dataset that is today primarily used for financial purposes (Minimum Hospital Data). We modelled 13,660,187 admissions between 2008 and 2018 in 90 (89%) Belgian acute-care hospitals using APR-DRG-specific logistic regression. We studied temporal trends in outcomes, hospital-level associations between outcomes, associations of outcomes with hospitals characteristics, and evaluated how many and which APR-DRGs explained between-hospital variation. 
 Findings: Between 2008 and 2018, average standardised mortality decreased from 3.4% to 3.1% and pLOS from 10.6% to 8.1%, with significant decreases observed for 181 (out of 243) and 216 (out of 247) APR-DRGs respectively. Readmissions, however, increased from 4.8% to 5.2%. Pearson correlations between rates in 2008 and 2018 were 0.53, 0.49, and 0.74 for mortality, readmission, and pLOS, respectively. Apart from the positive correlation between mortality and pLOS (ρ=0.46), no associations between outcomes were observed in 2018. For many APR-DRGs, the odds of mortality and pLOS were higher in Brussels and Wallonia than in Flanders and higher for general than for academic hospitals, whereas the opposite was observed for readmissions. We discovered that hospitals that performed well in 2008 continued to outperform other hospitals in 2018. Finally, we found that the significance of standardised outcomes seemed to be driven by a considerable number of APR-DRGs. For instance, hospitals with pLOS higher than expected had on average (range) 61 (25-142) APR-DRGs with significantly elevated pLOS.
 Interpretation: Between-hospital variation in outcomes is likely due to systemic hospital factors, rather than due to specific clinical groups. This urges a healthcare policy reform wherein longitudinal follow-up and benchmarking of outcomes should become the starting point towards targeted quality improvement interventions. As we will demonstrate during this presentation, using administrative data can be a valuable tool for this longitudinal follow-up, as it requires no additional workload, is readily available and reliable when applying adequate statistical modelling. 

Patient safety as a public health problem

Patient safety is an essential component of quality healthcare, which is what the general population is constantly demanding worldwide. Consequently, ensuring quality healthcare should not be a matter of clinical interest only but a public health priority so that all actions planned or implemented may have an impact at all levels and ensure intersectoral support to help the population remain safe when seeking and receiving health services. The definition and implementation of patient safety are currently circumscribed to the institutional setting. This article aims to present data that can help put into perspective the existing gaps pertaining to patient safety definition and fields of action, and conclude that there is room to work in public health in order to close those gaps. This requires understanding the complexities of the interactions between determinants of harm outside the physical setting where care is provided. These include community-level work, incorporation of knowledge from other disciplines in order to account for coverage, access and health outcomes, design strategies to counteract the impact that the absence of effective patient and people safety measures have on the general population and, in particular, on people differentially affected by the social determinants of health.

Teamwork and safety climate in Polish long-term care facilities: questionnaire reliability and usability

The Teamwork and Safety Climate Survey (TSCS) is one of the questionnaires used to measure patient safety. The questionnaire includes two scales: teamwork climate and safety climate. The objective of the study is the linguistic and cultural adaptation of the TSCS to Polish conditions and checking the reliability and usability of the tool in long-term care facilities. Firstly, the TSCS was translated into Polish. Then, a cross-sectional survey was conducted among the medical and auxiliary personnel of long-term care facilities all over Poland. The psychometric properties of the questionnaire were analysed (including Cronbach’s alpha coefficient). Correlations between the areas of the questionnaire and individual variables relating to facility parameters were also calculated. Respondents (n = 558) working in 26 different long-term care facilities participated in the study. The analysis has provided four scales instead of two of the original version of the questionnaire (teamwork climate, safety climate, ability to speak up and following the rules, work organisation). Correlation analysis revealed a number of significant correlations between the scales and individual variables corresponding to the parameters of long-term care facilities and respondents themselves. In conclusion, the Polish version of the TSCS may be a useful tool to measure aspects related to patient safety culture in long-term care facilities.

The burden of healthcare-associated infection in Moroccan hospitals: Systematic review and meta-analysis.

Healthcare-associated infections (HAI), also referred to as nosocomial infections, is defined as an infection acquired in a hospital setting. This infection is considered a HAI if it was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility. HAI are a major patient safety measure to be considered in hospitals.

Adverse events in the global healthcare practice of an Occupational Mutual Insurance Company in Spain.

Patient safety is currently a main issue in healthcare practice. Adverse events (AEs) management is a key instrument for the application of strategies to prevent harm to patients. To analyze the type, severity and preventability, according to validated scales, of AEs occurring annually in the healthcare practice of an Occupational Mutual Insurance Company in order to implement action plans to improve patient safety. We analyzed the reported AEs in an Incident Reporting System and AEs detected in the Audit program of clinical records as a result of treating injured or ill workers in our 88 ambulatory care centers. We detected 28 AEs in the clinical records (CR), representing 0.05 AE/CR, with maximum values in the COM sample (26 AEs, 0.11) and much lower in INT (1 AEs, 0.02) and MIN (1 AE, 0.02). The most frequent AE type was procedure-related, followed by infection and care. AEs of severity level D (11 cases) and E (9 cases) predominated, while level F was also detected (6 cases). Intermediate values in preventability (3 and 4) predominated, 61.5% were preventable. With the Incident Reporting System, 27 AEs were identified, predominated by procedural type. Most reported AE severities was in levels E (10 cases) and C (8 cases), 89% were preventable. Our company detects AEs via the Incident Reporting System and annual Audit program of clinical records, both of which are complementary, and may result in the implementation of more effective Patient Safety measures.

To err is human: A healthcare organization blueprint towards safety and reliability.

392 Background: In 2019, a comprehensive cancer center was audited by a regulatory agency that identified opportunities to improve the safe delivery of healthcare. Even though the organization has been engaged in multiple continuous improvement initiatives, we found that to run a complex enterprise efficiently, we needed to break silos, learn from the frontline, and educate and train leaders in a psychologically safe environment. The overarching goal is to improve our culture of safety by developing a safety-focused workforce, improving robust processes around high-harm events, increasing transparency/feedback regarding safety events, and advancing the institution towards a High Reliability Organization (HRO)1 with zero preventable patient harm. Methods: Key interventions implemented: 1. Revamped our Root Cause Analysis; 2. Developed a Quality Assurance Performance Improvement (QAPI)2 council with leadership from the enterprise and representatives of the Patient Family Advisory Program, patients of the organization; 3. Implemented a Tiered Readiness Briefing (TRB) 7 days a week; 4. Selection of Serious Safety Event Rate (SSER)3 as the organization's measurement of patient safety and made it transparent; 5. Implementation of a mandatory training program in HRO skills and tools necessary to change behaviour. Training of leadership first goal was to get their buy-in so that the rest of the workforce would comply with the training; 6. Created Priority Focus Areas (PFA) initiatives supported by QAPI, the board, and leadership- providing resources to improve widespread, problem-prone, high-risk issues. Also, a system of accountability. Results: From June 2020 to April 2023- 59% reduction on SSER and sustained rate <0.9; 96% of leaders and 86% of medical faculty trained in HRO; 100% of “Start the Clock” issues identified in TRB are acted on within 24 hrs.; PFA success: the creation of the Blood Shortage Safety Decision Matrix- resulted in no surgery cancellation due to blood shortage. Conclusions: Rigorously implementing HRO principles in a comprehensive and complex cancer center resulted in improved process outcomes and patient safety outcomes that significantly reduced serious safety events.

Gambaran Budaya Keselamatan Pasien di Rumah Sakit : Studi Kasus pada Area Manajemen Pelayanan

Patient safety is a system that makes patient care safer, including risk assessment, identification of patient risk management, reporting and analysis of incidents, the ability to learn from incidents and their follow-up, and implementation of solutions to minimize risks and prevent injuries caused by errors. as a result of carrying out an action or not taking the action that should be taken. The hospital inpatient room is devoted to services for patients requiring more handling related to patient safety measures. This case study aims to find out the description of patient safety culture in hospital inpatient rooms. This case study uses a sample of 16 nurses in the inpatient ward, and the instrument used is the Hospital Survey of Patient Safety Culture Version 2.0, translated into Indonesian. It consists of 42 questions in 5 parts. The questionnaire results describe positive or negative values. This shows that in all aspects of the questionnaire, indicators > 70%, namely positive responses including the work unit section 70%, your supervisor 73.45%, the communication section 97.93, the incident frequency report section 91.7%, and the natural hospital section promotes patient safety 78.42%. The results of each indicator show that the picture of patient safety culture in the Hospital Inpatient Room is good, with a positive response of 85.25%. This research hopes to improve performance in patient safety culture as a health service provider

Risk Management Strategies for Healthcare Organizations: A Comparative Analysis of Patient Safety Measures in Kenya

Purpose: The study sought to investigate the Risk Management Strategies for Healthcare Organizations: A Comparative Analysis of Patient Safety Measures in Kenya
 Materials and Methods: The study adopted a desktop methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library
 Results: The results revealed that risk management strategies play a crucial role in improving patient safety within healthcare organizations. By comparing different strategies, the research may highlight which ones are particularly effective in reducing errors and enhancing overall safety. The study also concludes that leadership styles and organizational culture have a significant impact on the success of risk management strategies. Healthcare organizations with supportive leadership and a culture of safety tend to perform better in patient safety measures.
 Unique contribution to theory, practice and policy: The study recommends that there should be a culture of safety that encourages reporting of errors and near misses, learning from mistakes, and implementing solutions to prevent recurrence. A culture of safety can foster trust, transparency, and accountability among healthcare staff and patients. Conduct regular risk assessments to identify potential hazards, vulnerabilities, and threats to patient safety and organizational performance. Risk assessments can help prioritize areas for improvement, allocate resources, and monitor progress.

An assessment of radiation safety practices for transgender and gender non-binary patients in Irish radiology departments

IntroductionStudies indicate there may be inadequate care given to transgender and non-binary (TGNB) patients in healthcare environments, with radiology departments not being equipped to cater for this group. There is currently a deficit in research concerning the use of radiation safety measures for TGNB patients. The purpose of this research was to examine opinions of Irish Radiation Safety Experts (RSE) on current status of radiation safety protocols and techniques in place for TGNB patients and consider any changes necessary. MethodologyTen semi-structured interviews were conducted with RSEs from eight Irish hospitals, including five radiation protection officers (RPO) and five medical physicists. Question included: current radiation safety protocols for TGNB patients, potential issues and challenges with current practice, and recommendations of new measures. Coding was used to facilitate content analysis for interpretation of findings. ResultsNo reference to TGNB patients in local policies or guidelines was evident. Interviews established key radiation safety risks including inadvertent exposure of the foetus and insensitive patient care. Prominent categories identified included additional education, gender identification at patient registration and consideration of current policies and guidelines. The extent to which RSEs promoted the implementation of further measures to radiology departments varied. ConclusionsA clear lack of guidance and instruction for radiation safety for TGNB patients is evident. Whilst there are few TGNB patients in Irish hospitals, participants believed that inclusive changes should be made concurrent with Ireland's evolving culture and in the interest of equality of patient safety. Implications for practiceInclusive changes should be made to radiology departments concurrent with Ireland's evolving culture. However, barriers to implementing such measures include a lack of available resources, investment, and instruction from authoritative bodies.

Patient Safety in Undergraduate Nursing: Student Perspective

Introduction: "Patient safety" needs to be addressed and discussed in a serious and responsible manner, where it is indispensable to equip future professionals to prevent adverse events and develop a culture of patient safety. Thus, there is a need to assess patient safety in undergraduate nursing, in the context of classroom teaching and curriculum internships. Objective: This study proposes to analyze students’ perception of patient safety at a university in Northeastern Brazil. Methodology: This is a unique instrumental exploratory case study using a qualitative approach. Participants were 12 students selected by intentional sampling. Data collection occurred via an online focus group. Data were processed in NVivo software, version 12.0 for qualitative research. Results: The data illustrated the students’ perception of patient safety in three categories: classroom teaching; curriculum internships; and attributes for the management of future nurses. Although the university does not offer a specific patient safety discipline, the issue is addressed from the start of the course, by all teachers in a satisfactory manner. Final comments: The case study found that training health professionals based on patient safety measures is one of the largest investments that universities can make, sharpening critical thinking in order to improve care and reduce hospital costs, and above all, preserve life.

Patient Safety Culture Analysis in Dental Hospital Using Dental Office Survey on Patient Safety Culture Questionnaire: A Cross-cultural Adaptation and Validation Study.

The culture of safety and patient safety management in dental practice lags compared with medical practice. Hospitals strive to pursue quality and safety of healthcare services, with evidence of patient safety incidents in medical practice demonstrating the importance of promoting a safety culture. Measuring patient safety culture is a necessary first step to improving safety culture in clinical settings. As a hospital, dental hospital should improve the quality and culture of patient safety. Thus, our objective was to conduct a cross-cultural adaptation of a US measure of dental office patient safety culture for use in Indonesian dental hospitals. A cross-sectional study was conducted on 200 respondents at a dental hospital in Java, Indonesia. The first stage includes cultural adaptation and translation, followed by developing a questionnaire that was tested through expert agreement and analysis of validity and reliability using Spearman, Cronbach correlation coefficients, and correlation coefficients between classes. The Dental Office Survey on Patient Safety Culture consists of 58 items and 10 dimensions (overall perceptions of patient safety and quality, organizational learning, teamwork, staff training, work pressure and pace, management support for patient safety, office processes and standardization, communication about errors, communication openness, and patient care tracking/follow-up). A total of 200 respondents with a response rate of 61.5% and 77 invalid responses due to incomplete filling, so 123 respondents were analyzed. The validity test results on 38 question items from 10 dimensions, with a sign of 0.05%, 35 items are declared valid. The Indonesian version of the Dental Office Survey on Patient Safety Culture shows good validity and good reliability and has the potential to be used to evaluate patient safety culture in dental hospitals in Indonesia.

Community Pharmacy Survey on Patient Safety Culture: A Pilot Study in Cairo

Background measuring perception of patient safety culture among pharmacists working in community pharmacies is critical to identify opportunities of improvement, and actions required to improve patient safety. The aim of this work is to measure patient safety culture among pharmacists working in community pharmacies. Methods a crosssectional study was performed among pharmacists working in community pharmacies in the center and south of Cairo. Pharmacy Survey on Patient Safety Culture (PSOPSC), developed by the Agency for Healthcare Research and Quality (AHRQ), was used to collect data. PSOPSC is a self- administered questionnaire containing 36 items that measure 11 dimensions of patient safety culture. Results the study included 210 community pharmacies with 95% response rate. The mean age of pharmacists was 28 ± 5.4 years and males represent 55% of the sample. The overall positive response percent (PRP) ranged between 35% and 69% with a mean of 57.4%. The highest PRP was identified in the domains of “Teamwork” (68, 97%), “Organizational learning–continuous improvement” (64, 93%) and “Patient counseling” (61, 83%). The PRP was less than 60% in six out of the eleven composites. The lowest PRP was found in the “staffing, work pressure, and pace “domain which scored 34 (98%). Conclusion The average overall patient safety culture of community pharmacists highlights the need to put patient safety on the strategic priority at the level of community pharmacies. Attention should be given to the areas of weakness mainly in the dimension of “Staffing, Work Pressure and Pace”. It is recommended to allocate staffs and working hours more adequately and train the community pharmacists on the importance and principles of patient safety.

Correlation between burnout and patient safety culture on nurses at private hospital in Yogyakarta, Indonesia

Introduction: The high workload of nurses can cause burnout. Burnout can occur if the number of patients admitted does not match the number of available nurses and facilities, and occurs for a long time. Burnout in nurses causes a lack of attention to the application of patient safety culture. This study aims to find out the correlation between burnout and patient safety culture among nurses at Private Hospital in Yogyakarta. Methods: Research design was descriptive cross-sectional method. There were 58 nurses, acquired by total sampling technique. We used the MBI-questionnaire to measure burnout levels and the HSOPSC questionnaire to measure patient safety culture. Results: The results of this study indicate that the burnout level is low as many as 58 people (100.0%), patient safety culture is fairly good as many as 41 people (70,7%) and burnout has a negative effect on patient safety culture, but has no significant relationship (p 0,200 and r -0,171). Conclusion: The burnout level of nurses is in low category, the patient safety culture of most nurses is fairly good and burnout has a negative effect on patient safety culture, this is because when burnout is felt by an individual, it will affect all individual activities both physically and mentally. Nurses are expected to be able to manage the workload so that they can avoid burnout and cooperate with hospital management to improve patient safety culture.

Development, validation, and results of a national endoscopy safety attitudes questionnaire (Endo-SAQ).

Background and study aims Safety attitudes are linked to patient outcomes. The Joint Advisory Group on Gastrointestinal Endoscopy (JAG) identifies the need to improve our understanding of safety culture in endoscopy. We describe the development and validation of the Endo-SAQ (endoscopy safety attitudes questionnaire) and the results of a national survey of staff attitudes. Methods Questions from the original SAQ were adapted to reflect endoscopy-specific content. This was refined by an expert group, followed by a pilot study to assess acceptability. The refined Endo-SAQ (comprising 35 questions across six domains) was disseminated to endoscopy staff across the UK and Ireland. Outcomes were domain scores and the percentage of positive responses (score ≥75/100) per domain. Descriptive and comparative analyses were performed. Binary logistic regression identified staff and service factors associated with positive scores. Validity and reliability of Endo-SAQ were assessed through psychometric analysis. Results After expert review, four questions in the preliminary Endo-SAQ were adjusted. Sixty-one participants undertook the pilot study with good acceptability. A total of 453 participants completed the refined Endo-SAQ. There were positive responses in teamwork, safety climate, job satisfaction, and working conditions domains. Endoscopists had significantly more positive responses to stress recognition and working conditions than nursing staff. JAG accreditation was associated with positive scores in safety climate and job satisfaction domains. Endo-SAQ met thresholds of construct validity and reliability. Conclusions Endoscopy staff had largely positive safety attitudes scores but there were significant differences across domains and staff. There is evidence for the validity and reliability of Endo-SAQ. Endo-SAQ could complement current measures of patient safety in endoscopy and be used in evaluation and research.

Brief Review Study on COVID-19 Risks for Complications in Preterm Birth and Protective Measures

Introduction: Conceptualized that pregnant women who are contracted COVID-19 face significantly higher risks for complications with regard to their health and well-being. Preterm birth is one of the complications observed, so there is a need to be agile and be able to discuss the multiple ways that would protect women. Purpose: This review study has the determination to bring out thoughtful, innovative, and insightful perceptions by analyzing literature studies on preterm birth due to COVID-19 and the multiple ways that would provide protective measures to women. Methodology: This is a review study of premature delivery due to COVID-19 and the manifold protective measures for women. The secondary data is collected from the literature search from various electronic databases such as PubMed, Google Scholar, and PubMed Central. Results: The study draws insights that advance the knowledge concerning preterm birth due to COVID-19 and the compounding ways that provide protective measures to women. Conclusion: This review study analyses the risks for complications to pregnant women contracting COVID specifically premature deliveries seen at an increased rate. For patient safety various measures have been studied systematically in multiple ways and has been applied in the healthcare system. Drawing insights from the literature, the review study frames various measures for patient safety that would help professionals have novel ideas to deal with these types of mishaps.