Patient Safety Program Research Articles

Patient safety culture and associated factors of regional public hospitals in Addis Ababa

BackgroundPatient safety culture is the result of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment, style, and proficiency of health providers’ safety management. Globally, millions of adverse events occur annually, with a significant burden on low- and middle-income countries. The burden of injuries and other harm to patients from adverse events is likely one of the top 10 causes of death and disability worldwide. This study aimed to assess patient safety culture and its associated factors in regional public hospitals in Addis Ababa.MethodsAn institution-based cross-sectional study was conducted among 494 healthcare professionals working at regional public hospitals in Addis Ababa. The data were collected using a pretested structured self-administered questionnaire from June 3 to July 30, 2023. The data were entered into Epi info version 7.2 and exported to SPSS version 26.0 for analysis. Binary logistic regression analysis was used to determine the associations between the patient safety culture (dependent variables) and socio-demographic factors, health care providers and system’s. Multicollinearity was checked using VIF, and the adequacy of the final model was assessed using the Hosmer and Lemeshow goodness-of-fit test.ResultOverall, 48.8% (95% CI: 44.3–53.1) of participants had a good patient safety culture, for a response rate of 93.3%. Factors significantly associated with patient safety culture, as identified through factor analysis, included having 6–10 years of experience (AOR = 1.81, 95% CI = 1.13–2.88), having more than 11 years of experience (AOR = 3.49, 95% CI = 1.27–9.56), reporting adverse events (AOR = 2.47, 95% CI = 1.37–4.45), participating in patient safety programs (AOR = 3.64, 95% CI = 1.91–6.92), and working in obstetrics and pediatric wards (AOR = 0.47, 95% CI = 0.23–0.94) and (AOR = 0.21, 95% CI = 0.097–0.44), respectively.ConclusionThe overall level of patient safety culture in regional public hospitals was low (< 75%). Factors such as having 6 or more years of experience, reporting adverse events, participating in patient safety programs, and working in obstetrics and pediatric wards were significantly associated with patient safety culture.

Non-punitive Approach in Patient Safety Program

Non-punitive Approach in Patient Safety Program

Patient Safety Culture in Pre-Post Partum and Perinatology Units

Introduction: Effective patient safety practices in pre-post partum and perinatology units are crucial for ensuring high-quality care for mothers and children. These practices are expected to reduce maternal and child mortality rates, which remain significant. Patient safety implementation in hospitals depends largely on the patient safety culture within each institution. Objective: This study aimed to assess the application of patient safety culture in pre-post partum and perinatology wards. Methods: The research employed a mixed-methods approach with a sequential explanatory design. Quantitative data were gathered using the AHRQ (Agency for Health Research and Quality) questionnaire. Meanwhile, the qualitative research used an instrumental case study approach insights were derived from in-depth interviews with 52 nurses working in these units. Results: Results show an overall positive response rate of 67.8% across the 12 dimensions of patient safety culture, indicating satisfactory levels. The dimension with the highest positive response rate is teamwork at 38%, while openness had the lowest at 6%. Challenges in patient safety program implementation include lack of safety culture surveys, inadequate incident reporting systems, high blaming culture, lack of support, delayed case reporting, and financial constraints. Reporting, analysis, and evaluation are predominantly limited to internal hospital processes. Conclusion: The obstacles encountered in implementing a patient safety culture are the behavior of healthcare workers and the lack of optimal support from management. The recommendations given are the formation of a Patient Safety Committee, education about safety culture for healthcare workers, Monitoring and evaluation of the patient safety program that has been implemented.

Contributory factors related to patient safety incidence: A nursing perspective.

There are growing concerns about patient safety and quality assurance enhancement in the healthcare setting because of the increase in the incidence of patient harm and adverse events over the years. This study explored the contributory factors associated with patient safety practices. The study was conducted in two private hospitals in Gauteng province, South Africa. A qualitative approach was used to gain an in-depth understanding of the issues pertaining to patient safety incidence. Purposive sampling was used to select professional nurses practicing within the two private hospitals. Thematic analysis was used. The study utilised the Donabedian model of patient safety and quality. The study revealed that majority of the professional nurses did not understand the concept of patient safety; there was poor communication between the multidisciplinary team. There was poor adherence to patient safety policies. Patient safety issues remain an issue of concern in public health. There is a need for nurses to be capacitated on the implementation of patient safety programmes as well as improving communication within the multidisciplinary team. Identifying and addressing risk and contributory factors will help reduce the global burden of patient harm. The study has presented the challenges as seen with patient safety and made recommendations on how to improve patient safety from the nursing perspective. It is anticipated that the results of this study may be used to create awareness on patient safety issues. This should promote a good healthcare climate in private healthcare institutions.

Building a NICU quality & safety infrastructure

The American Academy of Pediatrics (AAP) Standards for Levels of Neonatal Care, published in 2023, highlights key components of a Neonatal Patient Safety and Quality Improvement Program (NPSQIP). A comprehensive Neonatal Intensive Care Unit (NICU) quality and safety infrastructure (QSI) is based on four foundational domains: quality improvement, quality assurance, safety culture, and clinical guidelines. This paper serves as an operational guide for NICU clinical leaders and quality champions to navigate these domains and develop their local QSI to include the AAP NPSQIP standards.

Quality and Patient Safety Metrics: Developing a Structured Program for Improving Patient Care in the Department of Medicine at The Ottawa Hospital.

Despite increasing recognition of the importance of quality and patient safety in academic medicine, challenges remain with ensuring physician participation in quality assurance and quality improvement efforts, such as lack of compensation and enabling resources. An organizational culture that includes physician leadership and a supportive infrastructure is needed to encourage physician backing of quality and patient safety initiatives. The authors describe the development of a robust quality and patient safety program in the Department of Medicine at The Ottawa Hospital over the past 7 years and highlight how the department changed its organizational culture by prioritizing quality and patient safety and establishing the necessary infrastructure to support this program. Program development was characterized by 4 overarching themes: incentives, administrative structure and physician leadership, training and support, and system enhancements. As a result of the program, the department broadly implemented a standardized framework for conducting quality committee meetings and morbidity and mortality rounds and reviewing patient safety incidents and patient experience across its 16 divisions. This has led to 100% departmental compliance on corporate quality assurance metrics each year (e.g., regular multidisciplinary divisional quality committee meetings), along with physician participation in formal quality improvement initiatives that align with larger corporate goals. The authors reflect on lessons learned during the implementation of the program and the essential elements that contributed to its success. Next steps for the program include using a centralized repository of quality and patient safety data, including patient safety incident dashboards, to encourage greater divisional collaboration on quality improvement initiatives and continuous institutional learning over time. Another important avenue will be to create an academic hub for excellence in quality and a formal approach to reward and promote physicians for their quality work.

The Relationship between Patient Safety Culture and The Level of Knowledge of Health Personnel with Compliance in Patient Identification Implementation in Hospital

The basic principle of health care in health institutions that continues to require quality improvement is patient safety. This study aims to analyze the relationship between patient safety culture and the level of knowledge of health workers with compliance with patient identification. This research is quantitative analytical with an observational approach. Data was collected on 70 respondents by observing patient identification compliance, patient safety culture questionnaires, and the level of knowledge of health workers regarding patient identification. Data were analyzed using correlation coefficient analysis. The results of the analysis show that there is a significant relationship between patient safety culture and level of knowledge and compliance with patient identification (p = 0.000 &lt; 0.05). The findings of this study provide insight into the importance of patient safety culture and the level of knowledge of health workers in increasing their compliance in carrying out patient identification, especially in hospitals. This study suggests that management and related health workers should actively participate in implementing patient safety programs, especially those involved in patient identification, to achieve optimal patient safety outcomes.&#x0D; Keywords: Patient Safety Culture, Patient Identification, Hospital, Health personnel

Development of a Patient Safety Simulation Program for New Nurses in the Intensive Care Unit

Purpose: Intensive care units (ICUs) are departments that use high-risk drugs and medical devices. Therefore, patient safety is especially important in ICUs. However, new nurses in ICUs often lack patient safety competencies. Thus, it is necessary to improve patient safety competencies for new nurses working in ICUs.Methods: This methodological study was designed to develop a simulation program to improve patient-safety competencies among new nurses working in ICUs. To develop a patient-safety simulation program, we conducted a survey on educational needs and reviewed the core competencies of patient safety applicable to healthcare providers. Additionally, we conducted an expert validation process and a pilot test.Results: A simulation-based patient safety program was developed that spanned 4 weeks (240 minutes).Conclusion: The patient safety simulation program, which considered the characteristics and competence levels of new nurses working in ICUs, was found to be appropriate. This program is expected to improve the patient safety competencies of new intensive care nurses, thereby contributing to the creation of a safer ICU environment.

Practices Used to Improve Patient Safety Culture Among Healthcare Professionals in a Tertiary Care Hospital.

A patient safety culture primarily refers to the values, beliefs, attitudes, and behaviors within a healthcare setup in a community that assists in prioritizing patient safety and encouraging the reporting of errors and near-misses in that facility. There is a direct impact of patient safety culture on how well patient safety and quality improvement programs work. The aim of this cross-sectional descriptive study was to investigate the practices to improve patient safety culture and adverse event reporting practices among healthcare professionals in a tertiary care hospital located in Mirpur Azad Jammu and Kashmir. In the non-probability convenience sampling of this cross-sectional study, Divisional Headquarters Teaching Hospital in Mirpur, Azad Kashmir used the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture Hospital Survey to collect data about the perceptions of healthcare professionals regarding patient safety culture within their hospital to assess the trends of patient safety culture by obtaining longitudinal data. A pre-validated questionnaire that has undergone a rigorous trial of testing to maximize the reliability and accuracy of the outcomes was distributed among clinical staff (healthcare professionals who interact with patients on a daily basis, such as nurses, doctors, pharmacists, and laboratory technicians) and administrative staff (medical superintendent, deputy medical superintendent, assistant medical superintendent, heads of departments). A total of 312 questionnaires were returned (response rate, 76%). The study found that the dimension "supervisor/manager expectation and action promoting safety" had the highest positive response rate (65.16%), and "nonpunitive response" had the lowest (27.4%). Higher scores in "nonpunitive response to error" were associated with lower rates of medication errors, pressure ulcers, and surgical site infections, and higher scores in "frequency of event reporting" were associated with lower rates of medication errors, pressure ulcers, falls, hospital-acquired infections, and urinary tract infections. We suggest that in order for hospital staff to continue providing excellent, clinically safe treatment, a well-structured hospital culture promoting patient safety is necessary. Moreover, further study is needed to determine strategies to improve patient safety expertise and awareness, and lower the frequency of adverse occurrences.

A survey on the effects of patient safety training programs based on SBAR and FMEA techniques on the level of self-efficacy and observance of patient safety culture in Iran hospital, Shiraz in 2022-2023.

Patient safety and medical personnel self-efficacy are among the main factors involved in providing quality health services. Moreover, safety culture in an organization is considered one of the most critical factors regarding patients' safety. Therefore, the present study aimed to determine the effects of patient safety programs based on Situation, Background, Assessment, Recommendation (SBAR) and Failure Model Effects Analysis (FMEA) techniques on self-efficacy and patient safety culture in Iran Hospital of Shiraz in 2022-2023. This two-stage quasi-experimental study was conducted in 2022-2033. Considering inclusion criteria, the present study included 80 nurses working in Iran Hospital. The participants were divided into groups of SBAR (40 participants) and FMEA (40 participants). All the data were collected using a Hospital Survey on Patient Safety Culture questionnaire and Sherer General Self-Efficacy Scale. Then, the collected data were analyzed using SPSS 13, Fisher's exact test, paired t-test, and independent t-test with a significant level of P < 0.05. The mean score of total patient safety culture between the two groups was insignificant before the intervention (P = 0.58). However, it was more significant in the FMEA group than the SBAR group after the intervention (P < 0/05). In addition, the mean self-efficacy score between the two groups was insignificant before the intervention (P = 0.80). However, after the intervention, the mean score of the FMEA group was significantly higher than the SBAR group (P < 0.05). According to the findings of this study, there is a meaningful relationship between patient safety training programs based on SBAR and FMEA techniques on patient safety and self-efficacy of nurses; however, FMEA training has more positive effects on self-efficacy and patient safety compared to other techniques. As a result, these techniques, along with other plans, are recommended to authorities in order to help improve patient safety.

Medical errors and adverse events in israel during the COVID-19 pandemic

The pandemic has suddenly challenged many healthcare systems. These systems needed more time to adapt and adjust their patient safety, risk management, and quality improvement programs to the new situation. This study aimed to characterize the pandemic's impact on reporting medical adverse events compared to periods before the pandemic outbreak in Israel. This retrospective cohort study is based on an adverse event reporting database reported to the Israeli Ministry of Health. We analyzed the number and type of adverse events reported to the Ministry of Health in the years before the COVID-19 pandemic (pre-pandemic period 2018–2019) in comparison to the same type of events reported during the pandemic (pandemic period 2020–2021). We found significant differences in reporting of adverse medical events compared to the pre-pandemic period. The following types of events were reported significantly more: medical and surgical procedures, unexpected deaths in general hospitals, complications or deaths of the mother in-hospital and home birth, more severe complications, and stillbirth of born children, and higher escape rate from psychiatric hospitals. A significant decrease was observed in errors in the operation process and device malfunctions. The overall rate of reporting adverse events was higher during the pandemic than pre-pandemic. Reporting of specific types of adverse events increased compared to the pre-pandemic period, though some were reported less. It may be beneficial to try to understand what specific variables played a significant role in affecting those changes. This understanding may help the healthcare system prepare to cope better with future medical crises.

Attitudinal changes of undergraduate students learning online interprofessional education for patient safety: Comparative evaluation of an online program using the DID method.

Interprofessional education (IPE) can cultivate competencies in multidisciplinary collaboration for patient safety, and both face-to-face and online IPE programs have recently been introduced. This study aimed to elucidate the effects of the online IPE program on undergraduate students after the coronavirus disease 2019 pandemic. The difference-in-differences method was used to assess undergraduate students in the Schools of Medicine and Health Sciences and in the Faculty of Pharmacy at Takasaki University of Health and Welfare who participated in IPE programs at Gunma University (face-to-face IPE was implemented in 2019 and online IPE in 2020). We distributed a questionnaire that included modified versions of the Attitudes Toward Health Care Teams Scale (ATHCTS) and the Teamwork Attitudes Questionnaire (T-TAQ) to evaluate attitudes toward health-care teams and collaboration for patient safety, respectively, and then compared the differences. The mean score on the "team efficiency" subscale of the ATHCTS in the online IPE program was significantly lower than that in the face-to-face IPE program. Scores on the T-TAQ in two categories, "mutual support" and "communication", were significantly higher in the online IPE program, which suggests that it may have a similar effect on students learning collaborative practice for patient safety. However, due to technological difficulties, the online IPE program reduced the educational effects for "team efficiency". The improvements in "mutual support" and "communication" seen in the online IPE program, suggest its necessity for collaborative practice for patient safety. These findings suggest that an online IPE program for patient safety may provide better education effects as a whole, but efforts are needed to minimize the associated technological difficulties.

A Comprehensive Review of Effective Patient Safety and Quality Improvement Programs in Healthcare Facilities

A Comprehensive Review of Effective Patient Safety and Quality Improvement Programs in Healthcare Facilities

The Effect of Pre-Anesthesia Assessment on Patient Safety in the Operating Room

Background: The development of the science of anesthesia provides consideration in administering the type of anesthesia used. The pre-anesthesia assessment is the basis for planning the findings on the monitor during and after anesthesia. The completeness of the pre-anesthesia assessment has an important role in patient safety, if the anesthetic assessment is not properly completed it allows errors in the operation process. Patient safety goals are the main requirement to be implemented in all hospitals accredited by KARS. Patient safety goals intend to drive specific improvements in patient safety. This goal highlights problematic areas of health care. The wrong-site, wrong procedure and wrong-patient surgery are something that is worrying and not uncommon in the hospital. This error resulted from ineffective communication between members of the surgical team, not involving the patient in site marking, and no procedure for verifying the surgical site. Objective: The study aims to see the effect of the completeness of the pre-anesthesia assessment on patient safety. Methods: The research design is a cross-sectional study. The population in this study were patients who underwent surgery with a total sample of 70 people. Data processing through the stages of editing, coding, entry, and cleaning. Univariate analysis and bivariate analysis used the chi-square test with a 95% degree of confidence α = 0.05. Results: The results showed that the completeness of the pre-anesthesia assessment was complete with a percentage of 88.6%. Good patient safety with a percentage of 65.7%. There was no significant relationship between the completeness of the pre-anesthesia assessment and patient safety (p=0.076). Conclusions: To improve the implementation of pre-anesthesia assessments, hospitals need to review the completeness of filling out pre-anesthesia assessments by anesthesiologists before patients are operated on, to prevent errors in improving patient safety. Prepare facilities and infrastructure for the needs of patient safety programs by accreditation standards.

Nurses' perceptions about the patient safety climate in Primary Health Care.

to evaluate the patient safety climate in Primary Health Care from the perspective of nurses working in the services. a quantitative and cross-sectional study conducted with 148 nurses from a municipality in the state of São Paulo. The Brazilian version of the Primary Care Safety Questionnaire Survey and personal, professional, and organizational performance variables (intention to stay at work, job satisfaction, care quality, and frequency of incidents) were used. Parametric and non-parametric comparison tests and Spearman's correlation coefficient were performed, considering a 5% significance level. the safety climate was positive, varying from 4.52 to 5.33 and differing across districts for workload (p=0.0214) and leadership (p=0.0129). The safety climate professional variables and dimensions differed in relation to the frequency of incidents. Teamwork and safety and learning system were strongly correlated with job satisfaction and moderately with perceived care quality. teamwork and safety and learning system stood out for their positive correlations with job satisfaction and care quality. A positive safety climate favors the involvement of Primary Care nurses to develop improvement plans aligned with the National Patient Safety Program. (1) The safety climate is perceived differently across health districts. (2) There is a correlation between the climate dimensions and professional satisfaction. (3) Workload and leadership exert an influence on the safety climate perception. (4) There is a relationship between the safety climate and reporting of care-related incidents. (5) The safety climate is perceived differently among nurses regarding their role.

Implementation of Patient Safety Program at Hospital Royal Prima Medan in 2021

This research aims to know and analyze the implementation of the Patient Safety program and the factors that influence it at the Royal Prima Hospital Medan in 2021. This research is a mixed methods research that is a combination of qualitative and quantitative research. The research informants consisted of 1 person from the hospital health committee, 1 head of the inpatient ward, and 4 implementing nurses in the inpatient ward. The population is all implementing nurses in the inpatient rooms as many as 319 people. the sample was taken using the Taro Yamane formula for as many as 76 people. Data collection techniques through interviews, questionnaires, and documentation. Data analysis methods consist of qualitative analysis with descriptive methods and quantitatively using univariate, bivariate, and multivariate analysis using p multiple linear regression equation. The results of the study that the implementation of the patient safety program at the Royal Prima Hospital Medan in 2021 is quite good; there is an influence of the knowledge, attitude, workload, and supervision of the head of the room on the implementation of the Patient Safety program at the Royal Prima Hospital Medan in 2021.

Quality Improvement and Patient Safety Rounds—A New Paradigm in Cardiothoracic Surgery

BackgroundThe delivery of cardiothoracic health care is complex, and despite best efforts, adverse patient outcomes do occur. There is significant heterogeneity in morbidity and mortality rounds within and between institutions as well as undertones of a “blame and shame” culture prohibitive to meaningful quality assessment and improvement of patient care. The Quality Improvement and Patient Safety (QIPS) program was designed to address these issues. MethodsQIPS is built on the Donabedian model of quality and established phase-of-care adverse event analysis. It focuses on cultivating a culture of transparency. Every case review yields important demographic data, event factors, and the case inflection point, creating an institution-specific QIPS database. The QIPS format was presented by The Society of Thoracic Surgeons Workforce on Patient Safety at 2 Society of Thoracic Surgeons webinar series in December 2021 and August 2022. Descriptive data on both presentations were collected. ResultsThe December 2021 webinar had 75 unique viewers from 13 countries, and there were 343 asynchronous playbacks. The August 2022 webinar had 38 unique viewers from 9 countries and 310 asynchronous playbacks. ConclusionsThe standardized QIPS methods allow consistent recording of event factors and the inflection point, which are root causes of case morbidity or mortality. Dedication to the program will build a granular databank and identify recurring individual or system issues to launch quality improvement initiatives that address institution-specific needs. QIPS is simple, effective, and reproducible and seeks to create a culture of patient-centered quality and excellence in cardiothoracic surgery programs.

Standardizing Patient Safety Event Reporting between Care Delivered or Purchased by the Veterans Health Administration (VHA)

Increasing community care (CC) use by veterans has introduced new challenges in providing integrated care across the Veterans Health Administration (VHA) and CC. VHA's well-recognized patient safety program has been particularly challenging for CC staff to adopt and implement. To standardize VHA safety practices across both settings, VHA implemented the Patient Safety Guidebook in 2018. The authors compared national- and facility-level trends in VHA and CC safety event reporting post-Guidebook implementation. In this retrospective study using patient safety event data from VHA's event reporting system (2020-2022), the research team examined trends in patient safety events, adverse events, close calls (near misses), and recovery rates (ratio of close calls to adverse events plus close calls) in VHA and CC using linear regression models to determine whether the average changes in VHA and CC safety events at the national and facility levels per quarter were significant. A total of 499,332 safety events were reported in VHA and CC. Although VHA patient safety event trends were not significant (p > 0.05), there was a significant negative trend for adverse events (p = 0.02) and positive trends for close calls (p = 0.003) and recovery rates (p = 0.004). In CC there were significant negative trends for patient safety events and adverse events (p = 0.02) and a significant positive trend for recovery rates (p = 0.03). There was less variation in VHA than in CC facilities with significant decreases (for example, interquartile ranges in VHA and CC were 0.03 vs. 0.05, respectively). Fluctuations in different safety events over time were likely due to the disruption of care caused by COVID-19 as well as organizational factors. Notably, the increases in recovery rates reflect less staff focus on harmful events and more attention to close calls (preventable events). Although safety practice adoption from VHA to CC was feasible, additional implementation strategies are needed to sustain standardized safety reporting across settings.

Hubungan Fungsi Kepemimpinan Kepala Ruangan Dengan Kinerja Perawat Dalam Penerapan Keselamatan Pasien di Ruang Rawat Inap RSU GMIM Pancaran Kasih Manado

An effective leader is a prerequisite for determining safe treatment. The factor that affects the performance of nurses in the implementation of patient safety is leadership. The leadership role in improving patient safety in particular encourages and guarantees the implementation of patient safety programs in an integrated manner. Objective: To know the leadership functions of the chief of the room with the performance of nurses in the application of patient safety in the hospital room at RSU GMIM Pancaran Kasih Manado. Type of research: using descriptive analytical research methods with cross sectional approaches. The population of this research taken 115 population, The sample were 35 peoples using random sampling technique. Using the Chi-Square Statistical Test with a level of prosperity α ≤ 0,05. Result: Obtained a p=0,000 (α ≤ 0.05) ) that means there is a relationship between the function of the head of the chamber and the performance of nurses in the implementation of patient safety in the hospital's nursing room.The conclusion in this is that there is a link between the leadership function on the chief of the room and the performance of nurses in the application of patient safety in the Hospital Room of the RSU GMIM Pancaran Kasih Manado. The advice is expected to be the evaluation material for the future in order to create quality of nursing services.

A Nurse’s Performance, Personality, and Situation Awareness in Fall Risk Prevention

One indicator of a nurse’s performance evaluation regarding implementing patient safety programs in hospitals is the risk of a patient falling. An audit of fall risk prevention at Siloam Hospitals in Surabaya was used to evaluate nurses’ performance in preventing patient falls. The impact of personality and situation awareness characteristics on the nurse’s output performance in preventing fall risk was examined. A cross-sectional research design was used in the observational analytic research method. Forty-five nurses made up the total sample. The EPPS and SEAFAP questionnaire were the instruments used in the data analysis, which applied the linear regression test. The following personal characteristics have a p-value of 0.05 or less: Order (p-value 0.016), Autonomy (p-value 0.019), Affiliate (p-value 0.012), Succorance (p-value 0.012), and Nurturance (p-value 0.009). With a p-value of 0.040, situation awareness impacts output performance. Both overall personality and situation awareness have a p-value of 0.006 and influence output performance, respectively. Situation awareness and personality-based needs have an impact on output performance. To provide specific solutions to improve the probability of patients falling, the recommendations for enhancing the fall risk prevention programs can be carried out through discussion and interviews.