Patient Safety Procedures Research Articles

Analysis of Interpersonal Communication, Motivation and Attitudes towards the Implementation of Patient Safety in Hospital Inpatients

The background to this research is that effective integration of interpersonal communication, motivation and attitudes can strengthen the implementation of patient safety in the health service environment, especially in inpatient settings. The aim of this research is to analyze whether there is an influence of Interpersonal Communication, Motivation and Attitude on the implementation of Patient Safety. The stages of achievement in this research include several stages of observation, sample determination, using a cross sectional approach using a questionnaire and data processing using a data analysis method using multiple linear regression tests. This research method is collecting primary data by giving questionnaires to all nurses who are directly involved in efforts to provide services to all patients at Jati Husada Karanganyar General Hospital with a cross sectional design, the sample size is 69 nurses. The research data was then tested for linear regression at a significance level of 0.005. The results of this research are that the level of understanding and implementation of patient safety in the Jati Husada Karanganyar Hospital inpatient is good, which is 89.7% for the level of understanding (interpersonal communication, motivation and attitude), on the variables of Interpersonal Communication, Motivation and Attitude simultaneously. has a significant effect on the implementation of patient safety in the Jati Husada Karanganyar Hospital, which means that the higher the value of interpersonal communication, motivation and attitude, the more disciplined the nurses are in carrying out patient safety procedures, the variables Interpersonal Communication, motivation and attitude have a significant effect on the implementation of patient safety in Inpatient care at Jati Husada Karanganyar Hospital, where the influence is positive, which means that the better the nurse's attitude in implementing patient safety procedures, the higher the level of patient safety implementation.

Radiation safety of dentomaxillofacial radiology in Finland: Reported abnormal irradiation-related incidents during 2012–2022

IntroductionThis study evaluates adverse events (AEs) in dentomaxillofacial radiology (DMFR) in Finland, including their quantity, nature, and outcomes. It also compares reporting activity between public and private healthcare organizations, as they share same legal obligations to report AEs. Two-thirds of dental images are taken in public, the rest in private healthcare. MethodsIn Finland, radiation-related AEs are reported to the Radiation and Nuclear Safety Authority (STUK). We categorized DMFR-related AEs by nature, outcome, and imaging modality. We also submitted a questionnaire to STUK to gather information on their observations and remarks made during inspections of establishments providing dental imaging services. ResultsDuring 2012–2022, STUK received reports of 1343 DMFR-related AEs, mostly causing patient harm (92.9%) leading almost always to excessive radiation doses (99.7%). Private healthcare reported most AEs (65.2%), with municipal institutions reporting the remainder (34.8%). Intraoral-related AEs (20.0%) slightly outnumbered panoramic-related ones (18.7%), but the majority (56.7%) didn't specify the imaging modality. CBCT-related incidents were least reported (4.5%). During STUK's inspections, remarks mostly concerned deficiencies in practical quality assurance (31.3%) or technical quality assurance (32.9%). ConclusionDMFR-related AEs may be underreported despite legal obligations, with most stemming from human error, highlighting the need to enhance patient safety culture. There's a notable reporting gap between private and public healthcare providers relative to the number of dental radiographs conducted. Organizational deficiencies in practical and technical quality assurance underscore the importance of ongoing education, as well as monitoring by STUK. Implications for practiceEnhancing patient safety culture in dentistry, including dentomaxillofacial radiology, demands customized multiprofessional development, as unaltered patient safety procedures from medicine and secondary care may not align with dentistry's requirements.

Artificial Intelligence Can Be Regulated Using Current Patient Safety Procedures and Infrastructure in Hospitals

Artificial Intelligence Can Be Regulated Using Current Patient Safety Procedures and Infrastructure in Hospitals

Healthcare workers perceptions of patient safety culture in selected Ghanaian regional hospitals: a qualitative study

BackgroundPatient safety culture is an integral part of healthcare delivery both in Ghana and globally. Therefore, understanding how frontline health workers perceive patient safety culture and the factors that influence it is very important. This qualitative study examined the health workers’ perceptions of patient safety culture in selected regional hospitals in Ghana.ObjectiveThis study aimed to provide a voice concerning how frontline health workers perceive patient safety culture and explain the major barriers in ensuring it.MethodIn-depth semi-structured interviews were conducted with 42 health professionals in two regional government hospitals in Ghana from March to June 2022. Participants were purposively selected and included medical doctors, nurses, pharmacists, administrators, and clinical service staff members. The inclusion criteria were one or more years of clinical experience. Interviews were recorded and transcribed. Thematic analysis was used to identify themes.ResultThe health professionals interviewed were 38% male and 62% female, of whom 54% were nurses, 4% were midwives, 28% were medical doctors; lab technicians, pharmacists, and human resources workers represented 2% each; and 4% were critical health nurses. Among them, 64% held a diploma and 36% held a degree or above. This study identified four main areas: general knowledge of patient safety culture, guidelines and procedures, attitudes of frontline health workers, and upgrading patient safety culture.ConclusionsThis qualitative study presents a few areas for improvement in patient safety culture. Despite their positive attitudes and knowledge of patient safety, healthcare workers expressed concerns about the implementation of patient safety policies outlined by hospitals. Healthcare professionals perceived that curriculum training on patient safety during school education and the availability of dedicated officers for patient safety at their facilities may help improve patient safety.

Comparing hospital leadership and front-line workers’ perceptions of patient safety culture: an unbalanced panel study

Background/aimThis article examines the relationships between workers’ hospital leadership status, hospital front-line status and patient safety culture in hospitals throughout the USA. By identifying possible disparities in perception, targeted interventions...

Latent Tuberculosis Screening Among New Users of a Biologic or Targeted Synthetic Disease-Modifying Antirheumatic Drug: Gaps in Screening Overall and Among Janus Kinase Inhibitors.

We combined claims and electronic health record (EHR) data to provide contemporary and accurate estimates of latent tuberculosis (TB) screening among new users of a biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) and assess potential gaps in testing by drug type, patient characteristics, and practice. Our denominator population was patients in the Rheumatology Informatics System for Effectiveness (RISE) registry and Medicare using a b/tsDMARD in 2018 without a claim or prescription in the year prior. TB screening was assessed in both Medicare and RISE 1 and 3 years before the medication start date. We calculated the proportion screened overall, by medication class, and by practice. We tested for demographic differences in screening using logistic regression. In the year before drug starts, 65.6% of patients had any TB screening; in a 3-year window, 72.9% had any TB screening. Rates of screening within 1 year by drug type were greater or equal to the overall screening rate for most drugs except for JAK inhibitors (JAKis) (46%) and interleukin-17 inhibitors (IL-17is) (11.5%). A lower proportion of Hispanic and Asian patients were screened compared with White patients. Practice screening rates ranged from 20.0% to 92.9% of patients within 1 year. We report higher screening rates than have previously been published because of combining claims and EHR data. However, important safety gaps remain, namely, reduced screening among new users of a JAKi or IL-17i and among Asian and Hispanic patients, as well as low-performing practices. Educational initiatives, team-based care delivery, task shifting, and technological interventions to address observed gaps in patient safety procedures are needed.

Revealing the Secrets of Mubarak Clinic's Success: A Success Story in Undergoing Accreditation Surveys (Case Study)

Accreditation, which is defined as the process of quality evaluation by an independent institution based on a set of established standards, is granted to Mubarak Clinic by the Indonesia Healthcare Facility Accreditation Agency or Lembaga Akreditasi Fasilitas Kesehatan Indonesia (LAFKI). The research method used is a case study, as a form of qualitative research, not focusing on the quantity of acquired data but based on the quality of the obtained data. Mubarak Clinic has demonstrated excellence in several areas, but there is room for improvement, especially in human resource management, facility management, and patient safety procedures. By focusing efforts on areas that need improvement, Mubarak Clinic can continue to enhance the quality and safety of patient care.

Gossypiboma Post Cesarean Section: Patient Safety Review

Background: Operations in the pelvic area including cesarean section are often followed by unwanted events in the form of missing surgical instruments. The surgical device that is most often left behind during operations is surgical gauze and is known as a gossypiboma. Surgical gauze is often left in body cavities such as the peritoneum, pelvis, and retroperitoneal spaces. This surgical gauze can remain in the body for days, months, or even years before manifesting clinically. A granulomatous reaction around the surgical gauze may produce exudate followed by the formation of an abscess or fibrotic mass. Objective: To see the aspect of patient safety in cases of gossypiboma after cesarean section. Methods: Serial report of gossypiboma cases after cesarean section. Results and Discussion: Three cases of gossyfiboma were reported after cesarean section in Bali in 2017-2018. The diagnosis is made clinically according to complaints, and history of cesarean section and supported by supporting examinations such as BOF (Book-on-Filter), Ultra Sonography, and Computerized Tomography-Scan. Various surgical procedures were performed including sub-total colectomy laparotomy, right hemicolectomy laparotomy, and Hartman procedure laparotomy. All operations went well with good results too. Patient safety approaches and procedures must be carried out strictly to prevent a recurrence. Conclusion: Reports of three cases of gossypiboma after caesarean section are strongly related to patient safety procedures that are not performed in the operating room.

Effects of Nurses’ Perceptions of Patient Safety Rules and Procedures on Their Patient Safety Performance: The Mediating Roles of Communication about Errors and Coworker Support

Aim. This study aimed to (a) examine the relationship between staff nurses’ perceptions of patient safety rules and procedures and their patient safety performance and (b) investigate potential mediators of this relationship. Background. Implementation of effective management interventions to improve patient safety requires knowledge of the extent to which nurses’ perceptions of a hospital’s rules and procedures regarding patient safety affect their patient safety performance. Methods. This correlational study involved a secondary analysis of cross-sectional survey data collected from 1,053 staff nurses in South Korea. Structural equation modeling was employed to test the proposed mediation model. Five standardized measures were used to assess key study variables: patient safety compliance, patient safety participation, nurses’ perceptions of patient safety rules and procedures, communication about errors, and coworker support. Cronbach’s alpha values for the scales ranged from 0.82 to 0.90. Results. Nurses’ perceptions regarding the usefulness and effectiveness of rules and procedures about patient safety were positively related to their patient safety performance, measured in terms of safety compliance and participation behaviors. Communication about errors and coworker support showed significant mediating effects on these relationships. Conclusions. The findings indicate that the implementation of effective and useful rules and procedures for improving patient safety would facilitate error communication and coworker support, enhancing nurses’ patient safety performance. Implications for Nursing Management. Hospital administrators and nurse managers should consider how they can foster conditions in which nurses perceive rules and procedures regarding patient safety as useful and effective.

Emergency Management During Telehealth

The COVID-19 pandemic rapidly expanded telehealth utilization, spurring interest in patient safety and emergency procedures during treatment. The purpose of this report was to present safety procedures within a Veterans Affairs (VA)-affiliated telehealth physical therapy program treating medically complex older adults. Staff completed organizational and clinic-specific training for emergency procedures; these procedures were iteratively adapted through safety event debriefings and weekly meetings. Twenty-one individuals participated in the program. Clinicians completed 317 and 122 individual and group sessions, respectively, and reported 17 safety events. Four case examples highlight how safety procedures were adapted to mitigate risk and respond to emergencies.

The Effects of Patient Safety Culture Perception and Safety Control on the Patient Safety Management Activities of Psychiatric Ward Nurses

Purpose: To provide basic data to find ways to increase the patient safety management activities of psychiatric ward nurses and establish measures for patient safety.Methods: The research was conducted with psychiatric nurses who had worked for > 6 months in 9 psychiatric hospitals across 3 regions. Data collection spanned June 16 to July 7, 2022, the research tools being patient safety culture perception, safety control, and patient safety nursing activities.Results: A hierarchical regression analysis showed the factors influencing patient safety management activities. In Model 1, factors of the position of the subject and number of accident reports in the past year appeared significant (F=6.63, <i>p</i><.001); the explanatory power was 9.8 %. In Model 2, patient safety culture perception appeared significant (F=15.26, <i>p</i><.001); explanatory power increased to 45.1 %. In Model 3, safety control appeared significant (F=14.63, <i>p</i><.001); explanatory power increased to 46.6 %. Among the perceptions of patient safety culture, communication, and procedures, incident-reporting frequency and hospital environment were identified as significant.Conclusion: The factors for psychiatric nurses' patient safety management activities are patient safety culture perception and safety control. Patient safety culture perception is a particularly important factor, and a strategy is needed to increase it.

Digital competencies for Singapore’s national medical school curriculum: a qualitative study

ABSTRACT Studies have shown that national-level initiatives to equip medical students with relevant digital competencies carry many benefits. Yet, few countries have outlined such competencies for clinical practice in the core medical school curriculum. This paper identifies current training gaps at the national level in digital competencies needed by students in the formal curricula of all three medical schools in Singapore from the perspectives of clinical educators and institutional leaders. It bears implications for countries that intend to implement standardized learning objectives for training in these digital competencies. Findings were drawn from in-depth interviews with 19 clinical educators and leaders of local medical schools. Participants were recruited using purposive sampling. Data were interpreted using qualitative thematic analysis. Thirteen of the participants were clinical educators while 6 were deans or vice deans of education from one of the three medical schools in Singapore. While the schools have introduced some relevant courses, they are not standardized nationally. Moreover, the school’s niche areas have not been leveraged upon for training in digital competencies. Participants across all schools acknowledged that more formal training is needed in digital health, data management, and applying the principles of digital technologies. Participants also noted that the healthcare needs of the population, patient safety, and safe procedures in the utilization of digital healthcare technologies should be prioritized when determining the competencies needed by students. Additionally, participants highlighted the need for stronger collaboration among medical schools, and for a stronger link between current curriculum and clinical practice. The findings highlighted the need for better collaboration among medical schools in the sharing of educational resources and expertise. Furthermore, stronger collaborations with professional bodies and the healthcare system should be established to ensure that the goals and outcomes of medical education and the healthcare system are aligned.

Nursing Student Errors and Near Misses: Three Years of Data.

Understanding the magnitude of errors and near misses in all health care situations is crucial to preventing them from occurring in the future. However, little research is available on the type or extent of nursing student errors in the United States. Nursing student error and near miss data were submitted by more than 200 participating prelicensure nursing programs via a secured online repository. Medication errors represented more than half (58.8%, n = 613) of the total error and near-miss data (n = 1,042) submitted. Errors and near misses were attributed to students not adhering to three major patient safety procedures: checking the patient's identification, checking the patient's allergy status, and following the rights of medication administration. Results indicate collecting data on nursing students' errors and near misses can help nursing programs identify system issues, promote transparency, and make quality improvements. [J Nurs Educ. 2023;62(1):12-19.].

Patient safety culture awareness among healthcare providers in a tertiary hospital in Riyadh, Saudi Arabia.

Patient safety is a serious concern in the health care industry. To enhance patient safety, healthcare providers are expected to minimize accidental harm to patients and enhance the quality of patient-centered care. The main objective of this study is to explore the awareness of the patient safety culture among healthcare providers. It is further intended to assess key fields and factors that hinder patient safety adoption and determine the effects of demographic factors on healthcare providers' awareness of patient safety culture. This study applied a cross-sectional quantitative design. It was conducted in a tertiary hospital in Riyadh, Saudi Arabia. The participants consisted of all healthcare providers working in a specific tertiary hospital in Saudi Arabia. A random sampling technique was applied in this study. The study sample size was 409 participants. A valid and reliable questionnaire was used to collect the required data. The T-tests, ANOVA. And regression was used. The study found that there is a moderate level of patient safety culture awareness among healthcare providers. Moreover, the findings also revealed that the age group “31–40” showed statistically different awareness levels as compared to the “more than 50 years' age group” (p = 0.012). Also, this study has found that gender and education have a significant influence on the awareness level of patient safety culture while position and work area have no influence on the awareness level of patient safety culture among healthcare providers. Managers in healthcare institutions should develop speeder response plans and make them part of the patient safety culture. Institutions offering bachelor's degrees and postgraduate in nursing should pay more attention to the subject of patient safety. The government healthcare sector, together with the private healthcare sector, should continuously train healthcare providers on patient safety procedures to improve the patient safety culture. Healthcare providers should be encouraged to report errors made during diagnosis or treatments to avoid them in the future.

Pengalaman Perawat Menerapkan Prosedur Keselamatan Pada Klien Lanjut Usia

Patient safety procedures need to be done to prevent patient safety incidents. The purpose of the study is to explore the experience of room nurses applying patient safety procedures to elderly clients. Qualitative research design with phenomenological study approach. Participants are implementing nurses who have experience in caring for elderly patients as many as 6 nurses. Data collection was stopped when the data received were saturated through in-depth interviews. The method of analysis was the Interpretative phenomenological analysis (IPA). This research has passed the ethical clearance. Based on the results of the analysis, there are seven themes that can be found, namely understanding patient safety, the concept of elderly, forms of patient safety, supporting factors, inhibiting factors, efforts to overcome obstacles and the benefits of bothering patient safety procedures. Nurses' understanding of patient safety is an action to prevent incidents from occurring due to an action taken on the patient. In carrying out patient safety procedures for the elderly, the nurse finds several supporting and inhibiting factors. Nurses and patients feel safe when patient safety procedures are performed properly. Patient safety is a procedure that is closely related to the actions taken by the nurse. The experience of nurses in applying safety procedures to elderly clients provides a sense of security when take an action.
 Keywords: elderly, nurse, patient safety

Cultural Barriers and Enablers for Event Reporting

The purpose of this work was to identify opportunities for increasing event reporting based on a national survey on patient safety culture in a radiation medicine department. The National Hospital Patient Safety Culture Survey developed by the Agency for Healthcare Research and Quality (AHRQ) was disseminated to all staff members of our multi-center radiation medicine department via a web-based tool (Survey Monkey). The overall survey score was the fraction of responses deemed favorable for patient safety as per AHRQ guidelines. Apart from demographic questions, all 42 Likert-scale questions of the survey were mandatory. Completed surveys were amalgamated, and scores computed overall, per question, and per department work staff division. An additional survey question probed respondents on their annual frequency of event reporting with 6 choices ranging from none to over 21. The fraction of responses other than “None” yielded the event reporting rate. Linear regression analysis was performed for the division event reporting rate with each of the 42 questions scored per division. In addition, members of the incident learning system (ILS) analysis team completed an in-house survey to compare the impact of our internal ILS with the national Radiation Oncology Incident-Learning System (RO-ILS) in our department. The overall patient safety culture score was 67.8% (AHRQ average 65%). The department event reporting rate was 49% (> 50th and <75th percentile of all AHRQ respondents). The event reporting rate trends correlated well with survey scores on 4 of the 42 questions (Pearson correlation coefficient > 0.70, p-value <0.05). These were 1) It is just by chance that more serious mistakes don't happen around here (66.4% disagreed); 2) Staff feel like their mistakes are held against them (54% disagreed); 3) My supervisor/manager says a good word when he/she sees a job done according to established patient safety procedures (71.9% agreed); and 4) Mistakes have led to positive changes here (66.4% agreed). In the 2nd survey 82% of the respondents felt that having an ILS improves patient safety culture. 100% felt that even low-severity reports should be filed as fixing such errors may help improve processes in the long run. Neither ILS had a distinct relative advantage towards making our culture safer, but there were slight differences between perceptions of use patterns. Enablers for event reporting include staff perceiving a systematic department effort towards safety, a non-punitive environment for reporting, management appreciation for staff complying with safety guidelines, and impactful departmental responses to reported mistakes. Opposing perceptions are barriers. Having an ILS alongside a culture that supports even low-severity event reporting is perceived to improve reporting and patient safety. The AHRQ survey may be potentially useful for other departments seeking similar insights.

A provincial assessment of readiness for paediatric emergencies: What are the existing resource gaps in Alberta?

A large proportion of all emergency visits for paediatric patients across Canada are to general emergency departments (EDs). These centres may not be adequately equipped to provide optimal care for high acuity paediatric emergencies. The objective of this study was to determine paediatric readiness for general EDs and urgent care centres (UCCs) across Alberta and provide each centre with an overall weighted Paediatric Readiness Score (WPRS). A paediatric readiness assessment consisting of 55-questions normalized on a 100-point scale was used to survey 107 general EDs, UCCs, and tertiary paediatric EDs in Alberta, Canada. It addresses six primary categories, including Coordination of Patient Care, Physician/Nurse Staffing and Training, Quality Improvement Activities, Patient Safety Initiatives, Policies and Procedures, and Equipment and Supplies. Descriptive statistics were used to present the WPRS score among different groups. Linear regression models were used to explore factors associated with the score. The overall response rate was 59.8%. The median overall WPRS (/100) for all general EDs and UCCs was 48.4 ([interquartile range {IQR}] 17.6). Factors that were correlated with overall score included high paediatric patient volume (24.28, 95% confidence interval [CI]: 10.52 to 38.04) and involvement in a simulation education outreach program (9.38, 95% CI: 1.11 to 17.66). Based on this survey, the WPRS of EDs and UCCs across Alberta suggest a need to improve readiness to respond to high acuity paediatric emergencies in these settings.

Dementia and patient safety: A Gewirthian analysis

This article deals with the relationship between dementia and patient safety and proposes that measures to promote patient safety should be situated within a rights-based framework. This article calls for the current perspectives on patient safety to be broadened to further encompass patient safety procedures that encompass a holistic and individualistic view of the patient. Alan Gewirth’s Principle of Generic Consistency, as an underpinning moral principle, is applied in order to assess the appropriateness of current law, policy and practice. The article promotes the adoption of this principle as a moral justification for decisions that are taken in respect of patients with dementia and that are purported to protect their safety. It is argued that greater consideration needs to be given to ensuring that patient safety protocols are based upon a principled and empowering stance that does not impede the patient’s realisation of self-fulfilment. This process will be facilitated by adopting rights-based patient safety measures that promotes empowerment. Through the narrative of a fictional patient, Molly, the article presents a novel way of conceptualising patients with dementia, involving the movement from presenting the patient in terms of a linear, declining progression towards a conceptualisation of the patient as a persisting self.

The case of Patient Safety Indicator 12 (PSI12): use of administrative data to estimate the incidence of "Postoperative Pulmonary Embolism or Deep Vein Thrombosis". A pilot study in a General Hospital.

The AHRQ Quality Indicators (QIs) were created in order to both identify the performance and to track the improvement of patient safety. Patient Safety Indicator 12 (PSI12) is relative to the risk of Post Operatory Pulmonary Embolism or Deep Venous Thrombosis (PO DVT/PE). This pilot study has three main objectives. Firstly, to perform an analysis of the performance of different hospital wards by using administrative data; secondly, to analyze defects in the process that led to the occurrence of the adverse event; thirdly, reviewing the single PO DVT/PE. Data were extracted from a Hospital Information data flow (SIO) and compared to Clinical Discharge Record. PSI12 estimates were computed before and after the screening. Control Charts allowed the static analysis of performance between different hospital wards in 2014. The Ishikawa diagram was drawn for the analysis of the underlying causal process. The number of PSI12 cases provided by DRGs through SIO data flow decreased from 45 to six after the comparison with the correspondent clinical records. Four clinical records provided full information allowing the analysis of process. The Ishikawa Diagram identified the defects in the process of prophylaxis that resulted into a PO DVT/PE. The clinical records screening revealed a lower incidence of PO DVT/PE with respect to the DRGs statistics. Overall the PO DVT/PE occurrence in 2014 fell into the control limits, although the result could be undermined by the low quality of clinical records compilation. The failure in the prophylaxis procedure was imputable to pitfalls in the health care management and to the individual attitude towards patient safety procedures. In conclusion, the reliability and validity of administrative data in monitoring quality and safety are worthy to be explored in the context of further validation studies.

The evolution of patient safety procedures in an oral surgery department.

NHS Improvement highlights the importance of providing consistently safe care within the NHS. For dental professionals, this particularly concerns the reporting and avoidance of never events such as wrong tooth extraction and other serious incidents. Within the authors' unit, a number of infrequent never events and the national drive to introduce safety frameworks (NatSSIPs) has led to a reassessment of our safety procedures. In this paper, as part of our safety improvements, we discuss the chronological changes made in safety procedures following untoward events. Subsequently, we introduced a surgical safety briefing (the 'huddle') within the outpatient setting where we undertake invasive oral surgery procedures under local anaesthetic including intravenous sedation. By supplementing the 'huddle' with human factors training for all clinical staff there have been no further never events or serious incidents in the last two and a half years.