Safety Goals Research Articles

The ritualisation of the surgical safety checklist and its decoupling from patient safety goals.

Patient harm, patient safety and their governance have been ongoing concerns for policymakers, care providers and the public. In response to high rates of adverse events/medical errors, the World Health Organisation (WHO) advocated the use of surgical safety checklists (SSC) to improve safety in surgical care. Canadian health authorities subsequently made SSC use a mandatory organisational practice, with public reporting of safety indicators for compliance tied to pre-existing legislation and to reimbursements for surgical procedures. Perceived as the antidote for socio-technical issues in operating rooms (ORs), much of the SSC-related research has focused on assessing clinical and economic effectiveness, worker perceptions, attitudes and barriers to implementation. Suboptimal outcomes are attributed to implementations that ignored contexts. Using ethnographic data from a study of SSC at an urban teaching hospital (C&C), a critical lens and the concepts of ritual and ceremony, we examine how it is used, and theorise the nature and implications of that use. Two rituals, one improvised and one scripted, comprised C&C's SSC ceremony. Improvised performances produced dislocations that were ameliorated by scripted verification practices. This ceremony produced causally opaque links to patient safety goals and reproduced OR/medical culture. We discuss the theoretical contributions of the study and the implications for patient safety.

Healthcare Cost-effectiveness and Patient Safety: A Managerial Approach

This article investigates the interplay between healthcare cost-effectiveness and patient safety, emphasizing the pivotal role of managerial approaches. Through a comprehensive analysis, the study aims to unveil the economic implications of patient safety initiatives and delineate effective managerial strategies for optimizing resource allocation while prioritizing patient welfare. The findings contribute valuable insights to healthcare administrators, policymakers, and practitioners seeking to strike a balance between financial considerations and patient safety goals.

The Development of Clinical Education Model Based on Community of Practice for the Patient Safety Competency Achievement in Nursing Students: a Pls-Sem Approach

Background: Patient safety goals competence has not been achieved optimally by nursing students. The efforts to solve this condition are through improving clinical education based on community of practice. The study aims to analyze the development of a clinical education model based on community of practice for the patient safety goals competency achievement in nursing students. Methods: This research method was a cross-sectional approach. The number of respondents were 125 nurses in the professional student program who were taken by a purposive sampling technique. The study assessed student factors, clinical educator factors, learning facilities factors, clinical education factors, and outcome factors (patient safety goals competency outcomes through using questionnaire. Datacollected from February to April 2023 in university hospital, Semarang City, Central Cava, Indonesia. Data analysis techniques in this study used the Structural Equation Modeling (SEM) of AMOS 5.0 softwares package. Results: Student factors, clinical educator factors, and learning facility factors have a significant effect on clinical education based on community of practice with p value <0.05, t statistic > 1.96, with path coefficient in the range of 0.251 -0.353. Student factors, clinical educator factors, learning facility factors, and community of practice-based clinical education have a significant effect on patient safety goals competencyy achievement with p value <0.05, t statistics > 1.96, and the path coefficient is in the range 0.135-0.372. Conclusions: The clinical education model based on the community of practice is formed by student factors, clinical educator factors, learning facility factors, and community of practice-based clinical education that directly influence the achievement of patient safety goals competency by nursing students. The clinical education model based on community of practice should be applied as a learning method in improving patient safety goals competency outcomes for nursing students in the clinical area.

The relationship between clinical education and nursing students' patient safety competencies

Students play a crucial role in contributing to patient safety issues, a contribution that is significantly influenced by the implementation of clinical education. This study aimed to investigate the impact of clinical education on the achievement of patient safety goal competencies among nursing students. A cross-sectional study was conducted among 125 students in a nursing professional program at Sultan Agung Hospital in Semarang, Central Java, Indonesia. A total sampling technique was employed for sample recruitment. Data for the dependent variable were collected using an observation sheet, while data for the independent variable were collected using a structured questionnaire. Bivariate data analysis was performed using the Chi-square test. The bivariate analysis revealed a significant relationship between the implementation of clinical education and the achievement of patient safety goal competencies, with a p-value of 0.000 (p < 0.05) and a correlation coefficient of 0.609. The achievement of patient safety goal competencies can be facilitated through the implementation of optimal clinical education. Therefore, the implementation of clinical education must include a clinical education model based on the community of practice, making it easier for students to implement patient safety goals.

Assessing Compliance and Attitude to patient safety goal of patient identification among nurses: A cross-sectional observational survey

Abstract:
 Background: Patient identification is an important patient safety goal, healthcare providers have primary responsibility for verifying a patient's identity appropriately before intended interventions in the hospital. It is important for the hospital management team to develop and ensure the practice of patient identification policy.
 Objective: To assess knowledge, attitude, and compliance to patient safety goal of patient identification
 Methods: An observational cross-sectional study was conducted among 231 staff nurses of inpatient departments using random sampling at a tertiary hospital. The staff nurses were assessed for knowledge, attitude, and practices on patient safety of right patient identification using a knowledge-based questionnaire, structured validated questionnaire to measure attitude towards patient safety, and observational checklist for compliance to patient identification in practice
 Results: More than 50 percent of the nurses had a positive attitude towards reporting, acknowledging and dealing with mistakes, and concentrating on causes that could result in improving patient safety. Majority believed, management provided fair treatment for reporting but were more inclined and invested towards meeting targets of the organization. The compliance with all the identification practices was more than 80% with few areas of improvement identified for a compliance rate of less than 90%.
 Conclusion: Patient identification practices require special attention in health care delivery to avoid misleading errors and harm. It is thereby important to measure compliance and attitude of HCP at regular intervals to improve reporting and devising strategies. The compliance rate can be further improved by using strategies like standardizing approaches, provision of clear protocol, training, and patient education, and most importantly creating a culture of reporting and demonstrating management's inclination towards quality assurance

Analysis of the implementation of patient identification in inpatient care

Background: The World Health Organization (WHO) establishes mandatory patient safety goals to be implemented in all hospitals to reduce patient safety incidents and enhance the quality of healthcare services. Implementing patient identification in inpatient settings aimed to improve patient safety, minimize the risk of medical errors, and improve operational efficiency and patient satisfaction. Methods: The research was classified as qualitative and utilizes a case study methodology. Data was gathered by conducting in-depth interviews with all healthcare professionals (HPs) who offer services at the hospital. Data validation was performed by employing triangulation, which involves conducting patient interviews, making observations, and studying regulatory documents. Results: The interview findings from HPs revealed that the key themes that have emerged include patient identity, timeliness of patient identification, the procedure of patient identification, and patient identification in unique circumstances. Contributing aspects to the application of identification were workplace culture, hospital rules, and socialization. Workload, unique features of HPs, facilities, and patients were all elements that could hinder the process of identification. Conclusion: Based on the conducted research, patient identification has been effectively implemented in the inpatient setting in terms of HP's knowledge, execution of patient identification, and regulatory document completeness.

Ethical, legal, and information management aspects in the context of patient safety

Health systems around the world currently generate diverse health data related to their patients; their potential for use in the routine of health professionals is recognized; however, at the same time, patient safety is also widely discussed since, over the years, the patient's electronic medical record absorbs sensitive information, accumulated over time. In this sense, this study aimed to address ethical, legal, and information management aspects in the context of patient safety. This is a scoping review, conducted based on the methodological structure developed by the Joanna Briggs Institute and the checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, set in five stages: 1) identification of the research question, 2) bibliographic survey to search for relevant studies, 3) selection of studies, according to the criteria defined in this review, 4) data mapping and 5) presentation of results. The results showed that a) the articles, in general, pay much attention to patient safety, both in terms of data and also in terms of health; b) International patient safety goals were created to standardize care in private and public hospitals, c) The articles address patient safety by international patient safety goals and d) information leakage is becoming increasingly common, and actions are needed to minimize these situations. The conclusion shows that there is a lack of objective studies regarding the use of information technology in patient safety and that, due to the importance of these topics, both in public health and economic issues, more studies are necessary for an effective implementation that can generate practical results to patients and the country's healthcare system.

Comparing Medication History Capture Rates In-Person Versus Hybrid: A Multisite Pilot Study.

Purpose: Medication history is the method many organizations use to adhere to The Joint Commission's (TJC) National Patient Safety Goal (NPSG) to communicate accurate patient medication information. Literature is sparse comparing the number of medication histories completed in-person versus virtually. Methods: This is a single system, multi-site, retrospective observational study. Patients included were admitted through the Emergency Department during October 2022. The primary aim of this study compared the percent capture rates of medication history between 2 hybrid sites to an in-person site within a health-system. Our secondary objective compared the differences in the 'medication history acuity score' (MHAS), defined as the total number of edits, additions, and deletions made during a medication history. Results: The medication history capture rate at the in-person site was 74% and at the hybrid sites were 91% and 80%. There were no differences in total medications on each medication history between in-person and hybrid (11 [5-16] vs 11 [6-16]; P = .252). There were no differences in changes made on medication histories between in-person and hybrid (4 [1-7] vs 3 [1-7]; P = .595). Conclusions: Our study demonstrates that medication history capture rates and MHAS are comparable in both in-person and hybrid environments. This similarity suggests the feasibility of implementing hybrid models for medication history services in diverse healthcare settings, potentially enhancing the capacity of health systems to meet TJC NPSG. These findings indicate that hybrid models could be an effective strategy for healthcare systems to optimize their medication history services, especially in settings with varied patient volumes and site specialties.

A systematic review of clinical efficacy and safety of cell-based therapies in Alzheimer's disease.

This study aspires to estimate the efficacy and safety of cell-based treatments in AD. Observing the Joanna Briggs Institute (JBI) methods and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, a systematic search was accomplished in PubMed, Medical Literature Analysis and Retrieval System Online (Medline, via Ovid), Embase; Cochrane, and Cumulative Index of Nursing and Allied Health Literature - CINAHL (via EBSCO) databases up to June 2023. The relevant clinical studies in which cell-based therapies were utilized to manage AD were included. The risk of bias was evaluated using the JBI checklists, based on the study designs. Out of 1,014 screened records, a total of five studies with 70 individuals (including 59 patients receiving stem cells and 11 placebo controls) were included. In all these studies, despite the discrepancy in the origin of stem cells, cell density, and transplant site, safety goals were obtained. The intracerebroventricular injection of adipose-derived stromal vascular fraction (ADSVF) and umbilical cord-derived mesenchymal stem cells (UC-MSCs), the intravenous injection of Lomecel-B, and the bilateral hippocampi and right precuneus injection of UC-MSCs are not linked to any significant safety concerns, according to the five included studies. Studies also revealed improvements in biomarkers and clinical outcomes as a secondary outcome. Three studies had no control groups and there are concerns regarding the similarity of the groups in others. Also, there is considerable risk of bias regarding the outcome assessment scales. Cell-based therapies are well tolerated by AD patients, which emphasizes the need for further, carefully planned randomized studies to reach evidence-based clinical recommendations in this respect.

Towards “extended” safety goals (Conceptual exploration of safety goals for microreactors)

Towards “extended” safety goals (Conceptual exploration of safety goals for microreactors)

Alternative methods go green! Green toxicology as a sustainable approach for assessing chemical safety and designing safer chemicals

Green toxicology is marching chemistry into the 21st century. This emerging framework will transform how chemical safety is evaluated by incorporating evaluation of the hazards, exposures, and risks associated with chemicals into early product development in a way that minimizes adverse impacts on human and environmental health. The goal is to minimize toxic threats across entire supply chains through smarter designs and policies. Traditional animal testing methods are replaced by faster, cutting-edge innovations like organs-on-chips and artificial intelligence predictive models that are also more cost-effective. Core principles of green toxicology include utilizing alternative test methods, applying the precautionary principle, considering lifetime impacts, and emphasizing risk prevention over reaction. This paper provides an overview of these foundational concepts and describes current initiatives and future opportunities to advance the adoption of green toxicology approaches. Chal-lenges and limitations are also discussed. Green shoots are emerging with governments offering carrots like the European Green Deal to nudge industry. Noteworthy, animal rights and environ-mental groups have different ideas about the needs for testing and their consequences for animal use. Green toxicology represents the way forward to support both these societal needs with sufficient throughput and human relevance for hazard information and minimal animal suffering. Green toxi-cology thus sets the stage to synergize human health and ecological values. Overall, the integration of green chemistry and toxicology has potential to profoundly shift how chemical risks are evaluated and managed to achieve safety goals in a more ethical, ecologically-conscious manner.

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.

Effect of training program about PDCA process of quality on nurse interns practice of patient safety goals at the college of nursing, ABHA, King Khalid university

Effect of training program about PDCA process of quality on nurse interns practice of patient safety goals at the college of nursing, ABHA, King Khalid university

College Women's Perceptions of a Friend-Based Intervention to Prevent Alcohol-Involved Sexual Assault.

Sexual assault (SA), particularly alcohol-involved SA, remains prevalent among college women. Because SA often begins in social contexts, bystander intervention has become a popular approach to prevention. Bystander interventions train individuals to intervene on behalf of others, including strangers, despite research indicating that intervention is more likely to occur when the bystander has a relationship with the target. Shifting the focus to friends as potential bystanders capitalizes on the qualities of relationship and responsibility that facilitate intervention. College women (N = 35) participated in focus groups (N = 8) during which they viewed a video prototype of a friend-based motivational interviewing (FMI) intervention session conducted with a friend dyad and provided feedback about the relevance and feasibility of using such an approach to reduce SA among friends who drink together in social settings. Content analysis of focus group transcripts yielded three themes: a) Friends as Natural Bystanders; b) The Role of Alcohol in Intervention, and c) Receptivity to FMI intervention. Women indicated that they feel responsible for keeping their friends safe, and that this sense of responsibility facilitates helping behaviors. Women also described ways through which alcohol intoxication can affect helping behavior. Women expressed enthusiasm for the FMI intervention approach and identified its emphasis on friendship and flexible approaches to personal safety as strengths. Findings highlight the promise of FMI intervention approaches that capitalize on the strengths of women's friendship to create safety goals that align with participants' values and overcome barriers to intervention, including alcohol intoxication.

Радиологическая безопасность населения и персонала при двухкомпонентной ядерной энергетике

The Fundamentals of State Policy in the Field of Nuclear and Radiation Safety of the Russian Federation, approved by the President of the Russian Federation, indicate that the goal of state policy in this area is to ensure the protection of the population, considering modern requirements. The IAEA Fundamental Safety Principles emphasize the need to protect both current and future generations from radiation risks. The achievement of these safety goals is ensured by the development in Russia of new nuclear energy system based on a closed nuclear fuel cycle (CNFC) and fast neutron reactors (FNR). One of the objects of the new nuclear energy system is the Experimental Demonstration Energy Complex (EDEC) consisting of the BREST-OD-300 FNR, a reprocessing module and a fuel fabrication/refabrication module, located on the territory of JSC «SHK» in the Tomsk region. This article provides assessments of radiation carcinogenic risks for the population living in the 30-km zone of JSC «SHK» under normal operating conditions and for workers after potential emergency situations at EDEC facilities. The conditions for ensuring the protection of future generations of people are also justified. Radiation risk assessments are obtained directly from the dynamics of equivalent doses in human organs and tissues and modern risk models recommended by ICRP Publication 103. The predicted values of the risks of radiation carcinogenesis for the population and personnel are significantly lower than the current limits of NRB-99/2009 for both normal operation and potential exposure during accidents. It has been shown that transmutation of minor actinides during the development of CNFC based on FNR ensures the safety of future generations of people: it reduces the carcinogenic risk of americium by 213 times, neptunium by 101 times, and curium by 47 times. The effect of radiological equivalence of radioactive waste and natural uranium raw materials is achieved after 99 years of radioactive waste storage. Thus, the priority direction for the development of new nuclear power is the energy sector of the CNFC based on the FNR.

Hospital Responsibilities in Medical Services Based on Law no. 17 of 2023 concerning Health and Islamic Law

The hospital as one of the health service facilities is part of the health resources that have a vital role in creating a plenary health organization. Patient Safety Goals (SKP) have become a global issue in health services in hospitals so that they require special attention in their implementation. In addition to the SKP, each hospital also has an SOP (Standard Operating Procedure) that must be fulfilled by every worker, in this case the doctors at the hospital. When all procedures have been carried out and fulfilled by workers, the work provider, in this case the hospital, is obliged to protect their workers and how it is related with islamic law as an Indonesian way of life. The purpose of this study is to find out the legal responsibility of hospitals for medical accidents that occur in their hospitals according to Law No. 17 of 2023 and Islamic Law. The results of this study are that hospitals as providers of health services are required to implement hospital governance and clinical governance so that it can avoid problems with work accidents that might occur. So that the management of doctors and other workers must be good with the ultimate goal of increasing the health standard of the Indonesian people. Its fundamental in islamic way how important is health and trustworthiness in our lives especially if it connected with other lives

Impact of Transport Trends on Sustainability in the Western Balkans: A Future-Oriented Business Sector Perspective

This study examines the impact of emerging transport trends on the Western Balkans and their potential to improve the sustainability and efficiency of the transport sector in the region. In the context of global efforts to reduce environmental impacts and improve transport safety, the study aims to better understand the perspective of the business sector in order to align strategic planning for the introduction of new transport technologies and practices with the expectations of the business sector. Using a questionnaire-based survey on the Mentimeter platform, the study gathers insights from 49 transport and logistics experts. The analysis uses violin plots and heat maps to visualise the expected impact of the identified trends. The results show a consensus among the experts that the emerging trends are likely to lead to a reduction in accidents, congestion, and emissions, while at the same time increasing operating costs and investment in infrastructure. In particular, trends such as alternative fuels, electrification, and smart city initiatives are highlighted as important drivers for reducing emissions. The study concludes that while these trends are likely to lead to the achievement of environmental and safety goals, they also lead to economic challenges as operating costs increase and significant infrastructure investment is required. The study emphasises the need for strategic investment, policy adjustments, and capacity building to lead the Western Balkans towards a sustainable transport future.

Predictors of News Media Use in the COVID-19 Pandemic. A Brief Research Report

Aim: The research aimed to explore personal goals and COVID-19-related fear & worries as predictors of news media use during a health crisis – the COVID-19 pandemic. Method: A correlational online study was conducted with 371 subjects (Mage = 28.88, SDage = 10.25). Results: The results showed that, as expected, the importance of the health goal and the level of COVID-19 fear & worries positively predicted news media use, and the importance placed on the exciting life goal negatively predicted news media use during the COVID-19 pandemic. There was no significant relationship between the safety goal and news media use. However, the study revealed that COVID-19 fear & worries partially mediated the relationship between the safety goal and news media use. Conclusions: Study confirms that personal goals and negative emotions related to a crisis play an important role in understanding how and why people use the news media in a crisis. The limitations of the study and theoretical and practical implications are discussed.

The Effects of a Parent-Focused Social Media Intervention on Child Sun Safety: Pilot and Feasibility Study.

Middle childhood (ages 8-12 years) is a critical period for forming behavioral habits and reducing the risk for the development of skin cancer later in life. During this time, children develop more autonomy and spend more unsupervised time away from their parents. Professional agencies recommend that all children engage in regular sun protection behaviors and avoid the sun during peak daytime hours. Unfortunately, in middle childhood, child sun protection often declines and UV radiation exposure increases. Effective parenting involves balancing ways to encourage the child's increasing independence while providing practical assistance to ensure sun protection is implemented. The goal was to evaluate the feasibility, acceptability, and preliminary effects of Sun Safe Families, a Facebook group intervention for parents of children between 8 and 12 years of age. The team developed Facebook messages targeting parent knowledge, normative influences, sun safety barriers, planning and goal setting, confidence in implementing sun safety, communication, forming habits, and managing sun safety in risky situations. A total of 92 parents were enrolled, and the groups ran for 6 weeks. Feasibility was measured by enrollment and retention rates. Acceptability was measured by engagement in the Facebook groups. Satisfaction was assessed by a treatment evaluation. At pre- and post-intervention, parents completed measures of child sun protection, UV radiation exposure, sunburn, sun safety knowledge, child risk, barriers, sun protection self-efficacy, planning, sun safe habits, norms for child sun safety, and communication about sun safety. Enrollment (64.3%, 92/143) and retention (94.6%, 87/92) were good. On average, participants viewed 67.6% (56.8/84) of posts, "liked" 16.4% (13.77/84) of posts, commented on 14.8% (12.43/84) of posts, and voted on 46% (6.4/14) of polls. Satisfaction was excellent. From pre- to post-intervention, there were significant increases in child sun protection, sun exposure, and sunburn (P<.01; moderate effect sizes), as well as statistically significant increases in planning and self-efficacy (P<.05) and family norms and parent communication (P<.01). This study demonstrated high survey retention, acceptability, and satisfaction with the intervention. There were promising preliminary effects on child sun protection behaviors and parent sun protection attitudes and communication with their child. Replication with a larger sample size and a comparison condition is warranted.

Traffic safety versus accessibility: Investigating resistance against speed limit reductions

For traffic safety reasons, Sweden has lowered speed limits on major roads that lack directional separation of traffic. For some of these roads, regional authorities, municipalities, and other local stakeholders have sent appeals to the government opposing the implemented speed limit reductions. The appeals have mainly referred to negative effects on regional development and have suggested that the speed limit reductions be abandoned. This paper identifies the characteristics of roads where appeals against speed limit reductions have been filed and where local stakeholders claim that speed limit reductions are a threat to accessibility and regional development. The results of logistic regression modelling show that appeals are more likely for speed limit reductions on long road sections, on European roads, and in areas with a state university, and less likely in areas with high population density and areas defined as vulnerable by the Swedish Agency for Economic and Regional Growth. We investigated these policy conflicts using frame theory. In this paper, we identify two policy frames: speed limits for traffic safety and speed limits for regional development. These two policy frames are related to different views on how to best strive towards regional accessibility and safety goals in remote areas. The different views are likely not easily aligned by more information or facts since they concern deeper questions, such as what constitutes basic accessibility of good quality and how large risks are acceptable on the road network. This study thus uncovers not only a policy disagreement but a policy controversy in the Swedish context.