Patient Safety Problems Research Articles

Associations of wrong surgery with other critical healthcare quality and patient safety challenges: a cross-sectional nationwide study of 100 general hospitals in Spain.

Wrong surgery (wrong-site, wrong-procedure, or wrong-patient surgery) is among the most feared patient safety problems in hospitals. We aimed to evaluate associations between numeric assessment of risk assigned to wrong surgery with that of other healthcare quality and patient safety challenges. This nationwide study collected information from healthcare quality experts in charge of a clinical quality and/or patient safety department in general hospitals of ≥ 150 beds in Spain. Out of the 100 included hospitals, the highest strength of associations were observed with risk priority number (RPN) for hospital-acquired pressure ulcers, RPN for venous thromboembolism in hospitalized patients, RPN for incorrect patient identification, RPN for lack of informed consent for diagnostic or therapeutic procedures, RPN for catheter-related bacteremia, and RPN for adverse events and injuries due to medical devices related to use and/or design. These results are of potential interest for designing combined and coordinated strategies to improve patient safety in hospitals.

Hygienic assessment of the hospital environment and methods of providing medical care to patients at the stages of health care development in Russia in the XVIIIth–XIXth centuries

The article analyzes the problem of hygienic assessment of the conditions of the hospital environment and health-improving methods of treatment of patients of medical institutions at the stages of formation and development of healthcare in Russia in the XVIIIth and XIXth centuries. It has been established that in various historical periods, the problem of patient safety in medical organizations has always been the leading one in the management of people's health and the organization of healthcare as an agency that has been forming for several centuries. Organizational, legal, administrative, economic, and hygienic measures have been developed purposefully in the system of public health protection in Russia. This made it possible to improve the system of medical care on the basis of compliance with the provisions of hospital hygiene, such as the placement of patients in hospitals and compliance with the anti-epidemic regime. The systematization and analysis of the data from the Russian literature on the studied scientific problem were performed. Three leading directions of hospital hygiene development were established: organization of medical care, architectural and planning solutions, and therapeutic nutrition. The importance of developing the legislative framework of the listed areas at the state and departmental levels is shown. The results of the analysis of the application of sanitary and hygienic measures and scientific solutions of the XVIIIth to XIXth centuries confirm the need to use scientific, practical, and organizational experience in the introduction of new solutions to the modern system of medical care, including elements of hospital hygiene and patient safety. Proposals have been developed on the legality and prospects of using the historical experience of the development of preventive medicine and hygienic education of the XVIIIth and XIXth centuries, as well as the achievements of predecessors in the field of monitoring and accounting for the peculiarities of patient care and ensuring an anti-epidemic regime.

Patient safety problems in community-based mental health services: A qualitative exploration

Introduction Existing research has seldom examined patient safety problems experienced by service users accessing community mental healthcare, with the growing evidence base focusing largely on safety in psychiatric inpatient settings. Accordingly, there is poor understanding of safety issues in community-based mental health services as perceived by service users, carers, and healthcare professionals.ObjectivesThis study aims to explore safety problems in adult community-based mental health services, their causation, and priority areas for improving the safety of care provided in these services.MethodsIn-depth, semi-structured interviews and focus groups were conducted with users of community-based mental health services, carers, and healthcare professionals employed within these settings. Interview topic guides were designed jointly with stakeholders from these groups (N=7) and piloted (N=3). Interviews and focus groups will be transcribed, coded, and analysed using an inductive thematic analysis approach. Illustrative quotes will be extracted and used to describe the key themes that emerge from the analysis and their inter-relationships.ResultsThis presentation will provide an outline of patient safety as understood and experienced by key stakeholder groups. Study findings will explicate safety issues, healthcare system factors underpinning their causation, as well as practices which could improve safety in this context.ConclusionsThis research will help to advance understanding of the nature of patient safety problems in community-based mental healthcare services for adults, based on the experiences of service users, carers, and healthcare professionals within these services. The research will address key evidence gaps and represents an important step towards identifying areas which warrant intervention to improve patient safety.DisclosureNS is the director of London Safety and Training Solutions Ltd, which offers training in patient safety, implementation solutions and human factors to healthcare organisations and the pharmaceutical industry. The other authors have no competing interests.

Patient safety in community-based mental healthcare: A systematic scoping review

IntroductionThere is limited existing research about patient safety issues in mental healthcare. A lack of evidence is particularly pronounced in relation to safety in community-based mental health services, where the majority of care is provided. To date, reviews of mental health patient safety literature have focused primarily on inpatient care settings.ObjectivesThis systematic scoping review will aim to identify and synthesise literature about the types of patient safety problems in adult community-based mental health settings, the causes of these problems, and evaluated safety interventions in this care context.MethodsA systematic search was conducted on 19th June 2020 and refreshed on 23rd October 2021, across five databases: Medline, Embase, PsycINFO, Health Management Information Consortium, and Cumulative Index to Nursing and Allied Health Literature. The search strategy focused on three key elements: ‘mental health’, ‘patient safety’ and ‘community-based mental health services’. Retrieved articles were screened at title, abstract and subject heading level, followed by full-text screen of longlisted articles.ResultsIn this presentation, the findings of this systematic scoping review will be described, based on synthesised literature about safety incidents, broader care delivery problems, their causes, and evaluated patient safety interventions to address these issues.ConclusionsThis study will offer learning opportunities about the safety problems, contributory factors, and safety interventions in adult community-based mental health services, as described in the evidence base. Review findings will also help to ascertain gaps in existing research, which should be addressed in future studies.Disclosure NS is the director of London Safety and Training Solutions Ltd, which offers training in patient safety, implementation solutions and human factors to healthcare organisations and the pharmaceutical industry. The other authors have no competing interests.

Artificial intelligence and robot nurses: From nurse managers' perspective: A descriptive cross-sectional study.

This research was planned to identify nurse managers' opinions on artificial intelligence and robot nurses. As the concepts of artificial intelligence and robot nurses are becoming widespread in Turkey, nurse managers are expected to guide and cooperate with nurses in the future in regard to these technologies. The sample of the study consisted of 326 manager nurses, who were reached via the online questionnaire during the period of September to November 2021. A Nurse Managers Information Form and a Question Form on Artificial Intelligence and Robot Nurses were used to collect data. Data in this cross-sectional descriptive study were collected between September 2021 and November 2021 by the online survey method. The descriptive statistics of the data were analysed with numbers and percentages. The difference between the knowledge of artificial intelligence and robot nurses and demographic characteristics was analysed with the chi-square test. According to the findings, 66.9% of the nurse managers reported having heard the concepts of artificial intelligence and robot nurses previously. 67.2% stated that they thought that robot nurses would benefit the nursing profession, but 86.2% voiced disbelief that robots would replace nurses. The majority of the participating nurse managers reported that artificial intelligence and robot nurses would not replace nurses but would be beneficial for nurses and would reduce their workload. It should be ensured that the nurse managers plan the areas in the hospital where artificial intelligence and robot nurses will be used and determine the possible risks. Awareness should be increased with in-service trainings, and patient safety and ethical problems regarding the use of artificial intelligence and robot nurses should be identified.

Prospects of Hospital Information Systems and Patient Safety in Japan.

ObjectivesApproximately 20 years have passed since hospital information systems (HISs) featuring full-scale electronic medical records were first implemented in Japan. Patient safety is one of the most important of the several “safety” roles that HISs are expected to fulfill. However, insufficient research has analyzed the contribution of HISs to patient safety. This paper reviews the history of HISs in connection with patient safety in Japan and discusses the future of the patient safety function of HISs in a favorable environment for digitization.MethodsA review on the history of HISs with functions that contribute to patient safety was conducted, analyzing evidence from reports published by the Japanese government and papers on patient safety and HISs published in various countries.ResultsPatient safety has become a concern, and initiatives to promote patient safety have progressed simultaneously with the spread of HISs. To address the problem of patient safety, most large hospitals prioritize patients’ welfare when building HISs. However, no HIS-associated reduction in adverse events due to medical treatment could be confirmed.ConclusionsHISs are expected to help prevent medical accidents, such as patient- and drug-related errors. It is hoped that the patient safety functions of HISs will become generalized and contribute to patient safety in the future. To achieve this, the government and academic societies should provide regulations and guidelines on HISs and patient safety to the medical community and medical-device vendors. Furthermore, departments responsible for HISs and patient safety should collaborate to gather evidence for the effectiveness of HISs.

Dental antibiotic stewardship: study protocol for developing international consensus on a core outcome set

BackgroundAntimicrobial resistance is both a global public health and patient safety problem driven by overprescribing of antibiotic and other antimicrobial drugs. To conserve the effectiveness of antibiotics for future generations, antibiotic stewardship approaches to using them only where appropriate and necessary are advocated. Dentistry accounts for about 10% of antibiotic prescriptions across global healthcare, with 80% not in accordance with guidance in some countries. Core outcome sets enable the results of studies to be compared in order to maximise the value which can be derived from them. The aim of this study is to develop an international consensus on a core outcome set for dental antibiotic stewardship.MethodsConsensus on outcomes which are critical for inclusion in the core outcome set for dental antibiotic stewardship will be sought through two rounds of a Delphi survey (using the DelphiManager online system) followed by a final online consensus meeting. Thirty participants will be recruited to the Delphi Panel from across three stakeholder groups: ten dentists, ten academics and ten adults experienced with dental antibiotics as either a patient or parent/carer of a patient who has been prescribed them. Consensus will be achieved if more than 70% of the panel agree that an outcome is critical, with at least one from each stakeholder group in agreement. A long-list of candidate core outcomes has been developed from previously published studies with additions recommended by the steering group. The steering group will oversee development of the core outcome set and includes people from around the world with experience of dental antibiotics: clinicians, researchers and people with experience of being prescribed dental antibiotics and/or surviving an antibiotic resistant infection.DiscussionTo date, few studies of dental antibiotic stewardship have been published. Internationally, dental antibiotic guidelines and patterns of use vary widely, so a core outcome set is particularly important to facilitate meaningful comparisons between studies. This core outcome set will encompass antibiotic prescribing for both therapeutic indications, such as for people with acute infections, and for prophylactic indications, such as the prevention of distant site infections (like infective endocarditis) following dental procedures.

The WHO High 5s project: medication reconciliation in a German university hospital. A prospective observational cohort study

BackgroundEnsuring medication accuracy during transitions in care is one of the five highly prevalent patient safety problems focused on within the World Health Organization High 5s Project. Medication reconciliation is a standardized patient care process that can be used to address this problem. The aim of the current study is to implement medication reconciliation in a German university hospital. MethodsThe study was conducted at the Emergency Department of the University Hospital Aachen, Germany. All discrepancies between the Best Possible Medication History and the Admission Medication Order were documented and classified as documentation errors or medication errors. The type of error was also recorded. A negative binomial regression model was used to test several factors influencing the number of discrepancies. ResultsThe medications of 105 patients were reconciled. The mean number of discrepancies per patient was 4.6± 3.6, with a total of 298 medication errors and 189 documentation errors. The most common type of medication error was the omission of a drug (n=208; 69.8 %). In the negative binomial regression analysis, the care status (p=0.0015) as well as the number of preadmission drugs (p=0.0007) were significantly associated with medication errors. DiscussionA high number of discrepancies was detected and analysed. Patients admitted from nursing homes were less likely to have discrepancies in their medication reconciliation, perhaps because a structured documentation system for medications is already in place at nursing homes including error prone products (special dosage forms or food supplements). ConclusionsIn this study, medication reconciliation was implemented at a German full-care university hospital. The actual number of discrepancies observed strongly indicates the need for medication reconciliation at hospital admission.

Patient Safety Efforts in Tanzania: A Rapid Review of Two-Decades Efforts (2002-2022) to Inform Interventions towards Attainment of 2030 Targets

Introduction: The need to address the problem of patient safety has been a focus of World Health Assembly (WHA) meetings of 2002, 2019 and 2021. The 2019 WHA Resolution urged the Member States to take action on patient safety. We aimed to review patient safety efforts in Tanzania from 2002 to 2022 to inform improvement efforts towards the 2030 target. Methods: A rapid literature review was conducted between January 2002 and April 2022. We searched Google, PubMed and PubMed Central in April and May 2022 using the following search terms: PubMed—“patient safety Tanzania”, “blood safety in Tanzania”, “safe surgery Tanzania”, and “healthcare-associated infections Tanzania”; Google—“blood safety in Tanzania”, injection safety in Tanzania”, “infection prevention and control”, “radiation safety in health facilities in Tanzania”; and PubMed Central—“injection safety in Tanzania. Results: The search identified 4160 articles, of which 4053 were removed in initial screening; 21 were duplicates, giving 86 relevant articles for full screening. Of the 86 articles, 04 were removed after the full screening, hence remaining with 82 articles. Among the 82 eligible articles, 27 are on IPC, 26 on safe surgery, 12 on blood safety, 07 on radiation safety, 06 on injection safety, and 02 on medication safety. One article was relevant to—blood safety, IPC and injection safety; and one article was relevant to—IPC and injection safety. Conclusion: Most of the eligible literature was on IPC and safe surgery, followed by blood safety, radiation safety, injection safety and medication safety. The literature on IPC has highlighted the need to strengthen efforts to address AMR. Findings from the implementation of the safe surgery 2020 intervention warrants for its scale-up to other zones. There is a need to strengthen hemovigilance and pharmacovigilance functions; and strengthen quality management and assurance systems and regulatory functions to ensure radiation safety.

Is Electronic Health Record Safety a Paradox?

Is Electronic Health Record Safety a Paradox?

Assess the Level of Practice regarding Prevention of Pressure Ulcer in bedridden patients among Nurses

Background: Pressure ulcers are the common conditions among patients hospitalized in acute and chronic care facilities and impose significant burden on patients, their relatives and caregivers. Now days, pressure ulcers are recognized worldwide as one of the five most common causes of harm to patients and preventable patient safety problem. It is also increasingly described as an indicator of the quality of care provided by health care organization. However, pressure ulcers are largely preventable. All patients who are identified as being at risk should have a management plan to prevent development of pressure ulcer, optimize healing, and prevent complications of existing pressure ulcer. Objectives: 1. To assess the level of practice regarding prevention of pressure ulcer in bedridden patients among nurses. 2. To determine the association between pre-test practice scores of nurses regarding prevention of pressure ulcer in bedridden patients with selected sample characteristics. Methodology: The research design used for this study was non – experimental descriptive design. The study was conducted at a tertiary hospital in Bengaluru, Karnataka, India. Population comprises of nurses (staff nurses and student nurses) working in a selected hospital. The sample size selected for this study consists of 60 nurses (staff nurses -24 and student nurses -36) who were working in medical, surgical wards and Intensive Care Units (ICUs). Nurses providing care to the patients who are bed ridden for more than 48 hours were included in the study. Non – probability purposive sampling technique was used to select the samples. The tool used in this study was socio-demographic profile of nurses (separate tool for staff nurses and student nurses) and observational checklist to assess the practice. Result: The overall practice scores of the 60 nurses revealed that 40(66.67%) had good practice, whereas 20(33.33%) samples had average practice and none of them had poor practice. Among of 24 staff nurses; 20(83.33%) had good practice, whereas 4(16.67%) had average practice and none of them had poor practice. Out of 36 student nurses; 20(55.56%) had good practice, whereas 16(44.44%) samples had average practice and none of them had poor practice. It was found that among socio-demographic variables none had association with the practice of staff nurses and student nurses too. Conclusion: The study concluded that continuing education programmes are needed to improve the practices of nurses. Nurses must be motivated to provide back care and position change every second hourly in bedridden patients.

The Use of Innovative Materials in the Organization of Clinical Treatment in Dentistry

The article examines the features of the use of innovative materials in the organization of clinical treatment in dentistry. In modern conditions, solving the problem of patient safety is one of the main conditions for the functioning of medicine in general and dentistry in particular. For this reason, the search for innovations in the field of antimicrobial protection and, together with it, the functionality of various materials is one of the main tasks of researchers in the field of dentistry. Nanomaterials, which are made on the basis of graphene, are able to demonstrate excellent antimicrobial properties. These materials have the ability to disrupt the integrity of the bacterial cell membrane and produce reactive oxygen species (ROS).
 These materials are widely used in the manufacture of dentures, they are incorporated in the composition of composite resins and luting cements in the organization of restorative treatment, are used for the manufacture of adhesive materials. Many experts recognize that these materials are the future of dental practice, since they have the ability to provide a high level of functionality and safety.

How do patients respond to safety problems in ambulatory care? Results of a retrospective cross-sectional telephone survey

ObjectivesPatients in German ambulatory care frequently report patient safety problems (PSP). It is unclear whether patients report PSP back to their general practitioner (GP) or specialist in charge. This study...

Systems engineering analysis of diagnostic referral closed-loop processes

BackgroundClosing loops to complete diagnostic referrals remains a significant patient safety problem in most health systems, with 65%–73% failure rates and significant delays common despite years of improvement efforts, suggesting...

Using Text Mining Techniques to Identify Health Care Providers With Patient Safety Problems: Exploratory Study

BackgroundRegulatory bodies such as health care inspectorates can identify potential patient safety problems in health care providers by analyzing patient complaints. However, it is challenging to analyze the large number of complaints. Text mining techniques may help identify signals of problems with patient safety at health care providers.ObjectiveThe aim of this study was to explore whether employing text mining techniques on patient complaint databases can help identify potential problems with patient safety at health care providers and automatically predict the severity of patient complaints.MethodsWe performed an exploratory study on the complaints database of the Dutch Health and Youth Care Inspectorate with more than 22,000 written complaints. Severe complaints are defined as those cases where the inspectorate contact point experts deemed it worthy of a triage by the inspectorate, or complaints that led to direct action by the inspectorate. We investigated a range of supervised machine learning techniques to assign a severity label to complaints that can be used to prioritize which incoming complaints need the most attention. We studied several features based on the complaints’ written content, including sentiment analysis, to decide which were helpful for severity prediction. Finally, we showcased how we could combine these severity predictions and automatic keyword analysis on the complaints database and listed health care providers and their organization-specific complaints to determine the average severity of complaints per organization.ResultsA straightforward text classification approach using a bag-of-words feature representation worked best for the severity prediction of complaints. We obtained an accuracy of 87%-93% (2658-2990 of 3319 complaints) on the held-out test set and an F1 score of 45%-51% on the severe complaints. The skewed class distribution led to only reasonable recall (47%-54%) and precision (44%-49%) scores. The use of sentiment analysis for severity prediction was not helpful. By combining the predicted severity outcomes with an automatic keyword analysis, we identified several health care providers that could have patient safety problems.ConclusionsText mining techniques for analyzing complaints by civilians can support inspectorates. They can automatically predict the severity of the complaints, or they can be used for keyword analysis. This can help the inspectorate detect potential patient safety problems, or support prioritizing follow-up supervision activities by sorting complaints based on the severity per organization or per sector.

Workplace bullying, personality traits and health among hospital nurses: The mediating effect of social support.

This study aimed to explore the status of nursing staff's workplace bullying, personality traits, social support and mental health, to find out the predictors of nursing staff's health, and to explore whether social support is a mediator to regulate the impact of workplace bullying on mental health. Bullying could cause physical and psychological problems, and nursing workplace bullying causes not only health problems of nursing staff but also patient safety problems. "Workplace bullying" is a worthy topic to pay attention to. Only limited studies could be discovered about the mediating effects between workplace bullying and health. Cross-sectional and correlation designs were used. The STROBE was used as a checklist for this study. The results showed that the frequency of poor sleep quality ≥3days in recent 2weeks (p<.001), external control personality traits (p=.016), workplace bullying (p<.001) and less social support (p=.001) were the main predictors of the health problems among nurses, and social support was the mediator between workplace bullying and health problems. It is recommended that hospital managers should apply regular sleep-wake schedule by designing a biological clock-compliant shift in order to promote good sleep hygiene of the nurses. Providing educational programmes and building up policies to decrease workplace bullying and increase social supports are suggested. Hospital managers should provide education and training related to the prevention of bullying and establish communication and consultation channels for the bullied. Nursing managers should also educate nurses to establish effective social networks with family, friends and colleagues to prevent health problems.

Medication Error Concept and Reporting Practices in Saudi Arabia: A Multiregional Study Among Healthcare Professionals.

BackgroundMedication errors pose a risk for individual patients and for public health, with the misuse and overuse of medications being linked to severe patient safety problems. Therefore, the objective of this study was to investigate healthcare professionals’ (HCPs’) knowledge about medication errors, their knowledge about medication error reporting systems, and predictors for HCPs to report medication errors in Saudi Arabia.MethodsAn observational cross-sectional study was conducted among HCPs (physicians, pharmacists, and nurses) between January and March 2020. The study included 6 distinct locations in the Saudi Arabian regions of Hail, Al-Qassim, Al-Jouf, Al-Madinah, the eastern region, and the western region. Descriptive statistical and inferential analyses were computed using Statistical Package for the Social Sciences (SPSS) v.22.ResultsIn total, 980 questionnaires for 348 (35.5%) physicians, 144 (14.7%) pharmacists, and 488 (49.8%) nurses were distributed with a response rate of 100%. Interestingly, only 277 (28.3%) of the HCPs had a good understanding of the stages of medication errors. With regard to reporting practices, a high number of the HCPs, 576 (58.8%), had not reported medication errors in their workplaces, and nearly 369 (37.7%) of respondents said they believe that legal implications are a major barrier to the reporting of medication errors. More than half, 524 (53.5%), of HCPs revealed that no clear electronic system is available for the reporting of medication errors in most hospitals. In addition, 537 (54.8%), of the HCPs had not attended any training programs regarding medication error reporting systems within the past year, which is alarming.ConclusionOur study identified a huge lack of the reporting of medication errors, knowledge about medication error stages, and training on medication errors. Therefore, an urgent need to address these weaknesses exists.

Information Quality Frameworks for Digital Health Technologies: Systematic Review

BackgroundDigital health technologies (DHTs) generate a large volume of information used in health care for administrative, educational, research, and clinical purposes. The clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, some of which result from poor information quality (IQ).ObjectiveThis systematic review aims to synthesize an IQ framework that could be used to evaluate the extent to which digital health information is fit for clinical purposes.MethodsThe review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We searched Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, Global Health, ProQuest Dissertations and Theses Global, Scopus, and HMIC (the Health Management Information Consortium) from inception until October 2019. Multidimensional IQ frameworks for assessing DHTs used in the clinical context by health care professionals were included. A thematic synthesis approach was used to synthesize the Clinical Information Quality (CLIQ) framework for digital health.ResultsWe identified 10 existing IQ frameworks from which we developed the CLIQ framework for digital health with 13 unique dimensions: accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were categorized into 3 meaningful categories: availability, informativeness, and usability.ConclusionsThis systematic review highlights the importance of the IQ of DHTs and its relevance to patient safety. The CLIQ framework for digital health will be useful in evaluating and conceptualizing IQ issues associated with digital health, thus forestalling potential patient safety problems.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42018097142; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=97142International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2018-024722

Clinical Nursing Introduction Program for new graduate nurses in Sweden: study protocol for a prospective longitudinal cohort study

IntroductionHigh levels of nursing turnover represent a problem for healthcare organisations and patient safety. Experiences during the first years in the nursing profession have a significant impact on nurses’ future...

Patientensicherheit in der ambulanten Versorgung - Entwicklung und Anwendung eines CATI-Fragebogens (PSP-AMB) zur Erfassung patientensicherheitsrelevanter Probleme aus der Perspektive von Patient*innen ≥40 Jahre

The epidemiology of patient safety problems (PSPs) in the German ambulatory care sector is largely unknown. So far, there has been a lack of appropriate survey instruments. Development and application of a questionnaire (PSP-AMB), which records the epidemiology of PSP in the ambulatory care sector from the patient's perspective by using computer-assisted telephone interviews (CATI) on a population sample of ≥40-year-olds. The questionnaire items were developed by means of a literature search and guided interviews with ambulatory care physicians (N=10) and patients (N=20). The conversion to CATI and its application in the field was carried out by a survey institute. Qualitative (N=20) and quantitative (N=110) pretests were conducted before going into the field. The sample was generated via randomly generated fixed and mobile telephone numbers. PSP-AMB collects 32 PSPs in seven areas of medical treatment, from medical history-taking to practice organisation, and surveys all PSPs from the last 12 months (PSP-one-year incidence), PSPs with harm since the age of 40 (PSP-40+-prevalence), as well as PSPs resulting in death or severe need for care via proxy survey of the participants' parents and children. Detailed questions record the consequences and handling of PSPs and participants' socio-demographic data. Between May and October 2018, a total of 10,037 citizens (participation rate: 12.4%) were interviewed. The drop-out rate was 8.3%. The sample represents the German population aged 40 years or older. PSP-AMB is suitable for systematically recording PSPs in the ambulatory care sector from the patient's perspective. Thus, PSP-AMB meets the international demand to actively involve patients as a valuable source of information to improve patient safety.