Understanding Of Patient Safety Research Articles

The Correlation between Perception of Patient Safety and Professionalism and Adherence to Interprofessional Professionalism among Members of the Surgical Team

Introduction: Patient safety training and principles of professional commitment are considered as the most important skills in medical science education systems. Therefore, this study was conducted with the aim of determining the relationship between adherence to interprofessional professionalism and understanding of patient safety and professional commitment among surgical team members in one of the teaching hospitals affiliated to Qom University of Medical Sciences.
 Methods: This study is a descriptive-analytical study. The participants were 108 personnel working in the operating room and students of the operating room and intelligence in the field, who were included in the study as a census. In this study, two questionnaires were used: "Assessment of Interprofessional Professionalism" and "Questionnaire of Understanding of Patient Safety". The data were analyzed using descriptive statistics methods.
 Result: The results of the regression test showed that all areas of interprofessional behavior have a significant effect on the participants' understanding of patient safety (p<0.05). Pearson's test showed that there was a significant relationship between the scores of the safety culture field in the patient safety understanding questionnaire and the scores of the interprofessional character fields. (p< 0.05)
 Conclusion: The results of the present study showed that there is a positive and significant relationship between the scores of people's adherence to the principles of interprofessional behavior and their understanding of patient safety. Therefore, it can be said that the development of interprofessional character proficiencies of health team members can significantly increase their understanding of compliance with safety principles.

Patients\u2019 perception of safety climate in Irish general practice: a cross-sectional study

BackgroundAlthough patients have the potential to provide important information on patient safety, considerably fewer patient-report measures of safety climate (SC) have been applied in the primary care setting as compared to secondary care. Our aim was to examine the application of a patient-report measure of safety climate in an Irish population to understand patient perceptions of safety in general practice and identify potential areas for improvement. Specifically, our research questions were:1. What are patients’ perceptions of SC in Irish general practice?2. Do patient risk factors impact perceptions of SC?3. Do patient responses to an open-ended question about safety enhance our understanding of patient safety beyond that obtained from a quantitative measure of SC?MethodsThe Patient Perspective of Safety in General Practice (PPS-GP) survey was distributed to primary care patients in Ireland. The survey consisted of both Likert-response items, and free-text entry questions in relation to the safety of care. A series of five separate hierarchical regressions were used to examine the relationship between a range of patient-related variables and each of the survey subscales. A deductive content analysis approach was used to code the free-text responses.ResultsA total of 584 completed online and paper surveys were received. Respondents generally had positive perceptions of safety across all five SC subscales of the PPS-GP. Regarding patient risk factors, younger age and being of non-Irish nationality were consistently associated with more negative SC perceptions. Analysis of the free-text responses revealed considerably poorer patient perceptions (n = 85, 65.4%) of the safety experience in primary care.ConclusionOur findings indicate that despite being under-utilised, patients’ perceptions are a valuable source of information for measuring SC, with promising implications for safety improvement in general practice. Further consideration should be given to how best to utilise this data in order to improve safety in primary care.

Framing healthcare professionals in written adverse events: A discourse analysis.

Healthcare professionals have a major responsibility to protect patients from harm. Despite vast efforts to decrease the number of adverse events, the progression of patient safety has internationally been acknowledged as slow. From a social construction perspective, it has been argued that the understanding of patient safety is contextual based on historical and structural rules, and that this meaning construction points out different directions of possible patient safety actions. By focusing on fact construction and its productive and limiting effect on how something can be understood, we explored the discourses about healthcare professionals in 29 written reports of adverse events as reported by patients, relatives, and healthcare professionals. Through the analysis, a discourse about the healthcare professionals as experts was found. The expert role most dominantly included an understanding that adverse events were identified through physical signs and that patient safety could be prevented by more strictly following routines and work procedures. We drew upon the conclusion that these regimes of truth brought power to the expert discourse, to the point that it became difficult for patients and relatives to engage in patient safety actions on their terms.

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

Segurança do paciente entre estudantes de Enfermagem: uma revisão integrativa

Objetivo: analisar a produção científica acerca da compreensão dos graduandos de enfermagem sobre a segurança do paciente. Método: revisão integrativa com busca realizada de março a maio de 2020. O total de 15 artigos foi analisado com a tradução, leitura e interpretação dos resultados e comparação com o conhecimento teórico. Resultados: foram estabelecidos quatro eixos temáticos: o entendimento dos estudantes sobre segurança do paciente; os desafios da comunicação que podem afetar a segurança do paciente; os desafios do conhecimento dos estudantes e ensino sobre segurança do paciente e o papel do enfermeiro na construção da cultura de segurança. Conclusão: as compreensões dos estudantes foram: a insuficiente estrutura de ensino dos cursos de graduação, os dilemas éticos oriundos dos erros, o receio de infligirem danos aos indivíduos por desconhecimento das melhores práticas e os enfermeiros dos serviços vistos como protagonistas na conquista da cultura de segurança nas instituições de saúde.

Buprenorphine Induction Simulation: Focus on Patient Safety and Quality Care

BackgroundProvider education for medication-assisted treatment (MAT) primarily relies on didactic instruction. Clinical simulation that enhances the ability of advanced practice nurses (APRNs) is needed to effectively and safely implement MAT. MethodWe developed and conducted a pilot study of a MAT clinical simulation designed to enhance patient safety and increase MAT competency. ResultsClinical simulation improved APRN preparedness to effectively implement MAT. In addition, students indicated increased self-efficacy and better understanding of patient safety. ConclusionsClinical simulation is an innovative way to teach APRN students to effectively implement buprenorphine treatment while ensuring patient safety.

\u2018The big buzz\u2019: a qualitative study of how safe care is perceived, understood and improved in general practice

BackgroundExploring frontline staff perceptions of patient safety is important, because they largely determine how improvement interventions are understood and implemented. However, research evidence in this area is very limited. This study therefore: explores participants’ understanding of patient safety as a concept; describes the factors thought to contribute to patient safety incidents (PSIs); and identifies existing improvement actions and potential opportunities for future interventions to help mitigate risks.MethodsA total of 34 semi-structured interviews were conducted with 11 general practitioners, 12 practice nurses and 11 practice managers in the West of Scotland. The data were thematically analysed.ResultsPatient safety was considered an important and integral part of routine practice. Participants perceived a proportion of PSIs as being inevitable and therefore not preventable. However, there was consensus that most factors contributing to PSIs are amenable to improvement efforts and acknolwedgement that the potential exists for further enhancements in care procedures and systems. Most were aware of, or already using, a wide range of safety improvement tools for this purpose. While the vast majority was able to identify specific, safety-critical areas requiring further action, this was counter-balanced by the reality that additional resources were a decisive requirment.ConclusionThe perceptions of participants in this study are comparable with the international patient safety literature: frontline staff and clinicians are aware of and potentially able to address a wide range of safety threats. However, they require additional resources and support to do so.

How Is Patient Safety Understood by Healthcare Professionals? The Case of Bhutan.

ObjectiveThe aim of the study was to explore how the term patient safety is understood by healthcare professionals (nurses, educators, doctors, ward managers, senior managers, and health assistants), all of whom are responsible for promoting the patient safety agenda in the Bhutanese healthcare system.MethodsThe study was conducted as a naturalistic inquiry using qualitative exploratory descriptive inquiry. A purposeful sample of 94 healthcare professionals and managers was recruited from three different hospitals, a training institute, and the Ministry of Health. Data were collected via in-depth individual interviews. All data were subsequently analyzed using thematic analysis strategies.ResultsData analysis revealed variation in the understanding of patient safety among healthcare professionals. Although most participants understood patient safety as fundamentally concerning “doing no harm” or “reducing the risk of harm or injuries” to patients, some understood patient safety as simply having sturdy infrastructure/buildings with sufficient space to manage public health emergencies such as earthquakes, floods, and epidemics. Some confused patient safety with quality of care and patient rights.ConclusionsInadequate understanding of the term patient safety has potential to hinder improvement of patient safety processes and practices in the Bhutanese healthcare system. To improve patient safety in Bhutan’s healthcare system, patient safety training and education need to be provided to all categories of healthcare professionals.

Description and student self-evaluation of a pilot integrated small group learning and simulation programme for medical students in the first clinical year.

Contemporary education for medical students should be student-centred, integrated and contextualised. Small group learning promotes clinical reasoning and skills for lifelong learning. Simulation can provide experiential learning in a safe and controlled environment. We developed a weekly integrated problem-based learning and simulation programme (IPS) over two semesters in the first clinical year to augment clinical placement experience and contextualise theory into work-relevant practice. To evaluate the new programme at Kirkpatrick level 1. An anonymous survey of participating students. The programme was well liked. Students found the programme relevant and that they had a better understanding of patient safety and the assessment of the deteriorating patient. They felt it contributed to integration of theory and practice, clinical reasoning and the acquisition of non-technical skills, particularly affective and communication elements. This IPS programme in the first clinical year can deliver a student-centred curriculum to complement clinical placement that delivers the important requirements of contemporary medical student education.

Patient Safety Teaching to Our Students

BACKGROUND: Patient safety understanding and awareness is an important aspect of clinical medicine that should be taught throughout the medical school curriculum. We previously did not have any structured teaching around this topic. METHODS: During the course of our 6 weeks clerkship, we have 2 formal teaching encounters to discuss patient safety. During orientation, students complete a pre-intervention questionnaire and are introduced to 2 areas of focus during a 20 minute talk: OR Patient Safety and the IPASS handoff technique. They are given an assignment requesting them to document 3 examples of patient safety related observations. The second encounter is during week 5 of the clerkship where 1 hour is spent with the following activities: viewing a video clip of a patient safety story (Josie King Story), discussing the assignment, and reviewing the IPASS handoff with role playing. Following this session, the students are given the final post-intervention questionnaire. RESULTS: Students (n=105) felt more comfortable after the new curricular intervention. They felt more aware of medical errors within clinical medicine (P<.001), felt more familiar with the IPASS handoff to use it (P<.001), and felt OR patient safety is a comfortable topic to discuss (P<.001). DISCUSSION: Our patient safety curriculum appears to have a positive impact based on student perception. Feeling more aware of medical errors, being able to use the IPASS handoff, and being comfortable talking about aspects of OR safety are all areas students felt more competent in post-intervention.

Innovative Patient Safety Curriculum Using iPAD Game (PASSED) Improved Patient Safety Concepts in Undergraduate Medical Students.

While healthcare outcomes have improved significantly, the complex management of diseases in the hospitals has also escalated the risks in patient safety. Therefore, in the process of training medical students to be proficient in medical knowledge and skills, the importance of patient safety cannot be neglected. A new innovation using mobile apps gaming system (PAtient Safety in Surgical EDucation-PASSED) to teach medical students on patient safety was created. Students were taught concepts of patient safety followed by a gaming session using iPad games created by us. This study aims to evaluate the outcome of patient safety perception using the PASSED games created. An interactive iPad game focusing on patient safety issues was created by the undergraduate education team in the Department of Surgery, Yong Loo Lin School of Medicine at the National University of Singapore. The game employed the unique touched-screen feature with clinical scenarios extracted from the hospital sentinel events. Some of the questions were time sensitive, with extra bonus marks awarded if the student provided the correct answer within 10s. Students could reattempt the questions if the initial answer was wrong. However, this entailed demerit points. Third-year medical students posted to the Department of Surgery experienced this gaming system in a cohort of 55-60 students. Baseline understanding of the students on patient safety was evaluated using Attitudes to Patient Safety Questionnaire III (APSQ-III) prior to the game. A 20min talk on concept of patient safety using the WHO Patient Safety Guidelines was conducted. Following this, students downloaded the apps from ITune store and played with the game for 20-30min. The session ended with the students completing the postintervention questionnaire. A total of 221 3rd year medical students responded to the survey during the PASSED session. Majority of the students felt that the PASSED game had trained them to understand the processes of medical error (p<0.001), that their understanding on patient safety issues improved (p=0.007), and the training prepared them to prevent medical errors (p<0.001). Many students also recognized the importance of error reporting, where they felt comfortable reporting errors committed by themselves (p<0.001) or by other people (p<0.001). They also felt comfortable discussing with the supervisor on medical errors (p<0.001). Students responded that better teamwork will reduce medical errors (p=0.003), and teaching teamwork skills will reduce medical errors (p=0.002). After the PASSED session, students felt that patients could play an important role in preventing medical errors (p<0.001). They felt that patient safety should be emphasized in undergraduate training (p=0.024). The level of understanding about concepts of patient safety was also found to improve progressively from the 2nd posting to the 5th posting for both the pre-PASSED and post-PASSED intervention. The pre-PASSED scores for Posting 2 (3.59±1.931), Posting 3 (4.11±1.833), Posting 4 (4.84±1.653), and Posting 5 (4.88±1.642) were significantly higher than the post-PASSED scores for Posting 2 (4.46±2.020), Posting 3 (5.17±1.845), Posting 4 (5.88±1.843), and Posting 5 (5.80±1.843), respectively (p<0.001). Using iPad game (PASSED) to enhance the patient safety teaching has successfully improved the awareness and understanding of patient safety in clinical practice. This training model can be used to teach more senior medical students on the complexity of patient safety issues in medicine.

Applied Use of Safety Event Occurrence Control Charts of Harm and Non-Harm Events: A Case Study.

Most hospitals use occurrence reporting systems that facilitate identifying serious events that lead to root cause investigations. Thus, the events catalyze improvement efforts to mitigate patient harm. A serious limitation is that only a few of the occurrences are investigated. A challenge is leveraging the data to generate knowledge. The goal is to present a methodology to supplement these incident assessment efforts. The framework affords an enhanced understanding of patient safety through the use of control charts to monitor non-harm and harm incidents simultaneously. This approach can identify harm and non-harm reporting rates and also can facilitate monitoring occurrence trends. This method also can expedite identifying changes in workflow, processes, or safety culture. Although unable to identify root causes, this approach can identify changes in near real time. This approach also supports evaluating safety or policy interventions that may not be observable in annual safety climate surveys.

A research agenda on patient safety in primary care. Recommendations by the LINNEAUS collaboration on patient safety in primary care

ABSTRACTBackground: Healthcare can cause avoidable serious harm to patients. Primary care is not an exception, and the relative lack of research in this area lends urgency to a better understanding of patient safety, the future research agenda and the development of primary care oriented safety programmes.Objective: To outline a research agenda for patient safety improvement in primary care in Europe and beyond.Methods: The LINNEAUS collaboration partners analysed existing research on epidemiology and classification of errors, diagnostic and medication errors, safety culture, and learning for and improving patient safety. We discussed ideas for future research in several meetings, workshops and congresses with LINNEAUS collaboration partners, practising GPs, researchers in this field, and policy makers.Results: This paper summarizes and integrates the outcomes of the LINNEAUS collaboration on patient safety in primary care. It proposes a research agenda on improvement strategies for patient safety in primary care. In addition, it provides background information to help to connect research in this field with practicing GPs and other healthcare workers in primary care.Conclusion: Future research studies should target specific primary care domains, using prospective methods and innovative methods such as patient involvement.

Would you admit your mother to the residency service? Introducing the JCHIMP resident safety column

There remain tremendous opportunities to improve the stability and safety of American health care. Within this context, residents and residency programs face two essential questions: how to reduce the risk to patients resulting from resident inexperience, and how to change our programs to create the safer physician of the future? The spread of side-by-side teaching and non-teaching services creates a natural setting to study these questions and improve both services. When asked the question, “Would you admit your mother to the resident service?”, many of us respond, “It depends”. We are focusing this column on helping programs answer this question definitively in the positive, share potential best practices, and underscore community hospital's contribution to our understanding of patient safety.

Involvement of patients with cancer in patient safety: a qualitative study of current practices, potentials and barriers

BackgroundPatient involvement in patient safety is widely advocated but knowledge regarding implementation of the concept in clinical practice is sparse.ObjectiveTo investigate existing practices for patient involvement in patient safety, and...

Knowledge, skills, and attitudes of medical students to patient safety: a cross‐sectional pilot investigation in China

To reduce harm caused by health care is a global priority. Medical students should be able to recognize unsafe conditions, systematically report errors, and near misses, investigate and improve such systems with a thorough understanding of human fallibility, and disclose errors to patients. Therefore, incorporating knowledge about patient safety into medical school curriculums is an urgent necessity. To describe the extent to which Chinese medical students have patient safety in their knowledge, skills, and attitudes so as to provide evidence for implementation of a patient safety curriculum in medical schools, and to assess the quality of this investigative questionnaire. Our questionnaire of 31 items was developed based on a 2008 WHO pilot study for a patient safety curriculum guide. Our investigation was conducted in three university medical schools in China. Year 3 and year 4 medical students were asked to complete an anonymous questionnaire in their classroom settings. All items were scored from 1 to 5. Differences in responses among different universities, genders, and levels, as well as the validity and reliability of the questionnaire, were analyzed using SPSS 15.0. A total of 500 questionnaires were distributed, and 143 male and 262 female students completed the survey. An average of 0.96% of survey questions were not answered, of which the most frequently unanswered item was "what will happen when medical error occurs?" The students' attitudes to learning about patient safety were positive, although their knowledge of medical error and how to report error was poor. There were no statistical differences among different medical schools and levels in any item responses. The only gender difference appeared in the response to "I would like to discuss with others when I made a medical error." There was a good coherence of reliability in sections 2, 3, and 4 of the questionnaire (Cronbach's alpha > 0.8), while sections 5 and 6 scored as less reliable. The validity of the questionnaire was good. Although medical students' understanding of patient safety is very poor in China, the students have a positive attitudes to learning about the knowledge of patient safety in their future careers.

Measuring Administrators’ and Direct Care Workers’ Perceptions of the Safety Culture in Assisted Living Facilities

Further understanding of patient safety in health care is still needed. This is particularly evident in long term care settings, where relatively little information exists. Safety culture has emerged as a critical component of efforts to improve patient safety; it is strongly associated with iniatatives that influence patient safety and quality of care. The safety culture of a large sample of assisted living (AL) facilities was examined. The Nursing Home Survey on Patient Safety Culture (NHPSC) was modified and used to examine safety culture. A random sample of AL settings from all 50 states was selected to participate. Respondents were AL administrators and direct care workers (DCWs) who completed the modified safety culture survey. The applied properties of the instrument are examined. A summary score for administrators and DCWs for each NHPSC item is also presented. These summary scores have a range from 0 to 100, with low scores representing a poor safety culture (and vice versa). Information was received from 572 administrators (response rate = 57%) and 3,620 DCWs (response rate = 51%). The scores, using the 0-100 scale, fell into the 48-72 range for administrators and the 40-68 range for DCWs. Many of the scores were similar to those previously found in nursing homes. AL is recognized as one of the fastest-growing institutional components of the long term care industry. The modified NHPSC performed well. Some areas of safety culture were perceived less favorably than in nursing homes. As such, some further attention to safety culture in AL is warranted. This study provides a first step toward assessing safety culture in this underexamined setting.

Healthcare professionals’ understanding of patient safety: relevance to the development of person-centered medicine

Aims and Objectives: The success of patient safety initiatives in the development of person-centered models of clinical care depends on the engagement of ‘frontline’ clinical staff. However, little is known about how such staff understand and act on notions of risk and safety. We aimed to explore this understanding through qualitative inductive analysis of interview data from healthcare staff in an acute hospital. Method and Results: We interviewed 43 members of staff and analysed the interviews using a grounded theory approach. ‘Patient safety’ was understood within each participant’s own work context. We noted discrepancies in that understanding, with ‘vertical’ differences (variations in experience and seniority) within one professional group and ‘horizontal’ differences between groups. Risk was generally seen as intrinsic to daily working life. Participants focus on managing rather than trying to avoid risk. An informal but complex conceptualisation identified ‘professional’ and ‘situational’ risk. Participants also distinguished ‘acceptable’ from ‘unacceptable’ risk and ‘avoidable’ from ‘unavoidable’ risk. These contrasts seemed to help them decide whether it is feasible, necessary and/or beneficial to intervene when a risk appears. Further, different individuals and groups were recognized to have understanding and ‘ownership’ of specific risks or groups of risks. Formal manifestations of safety systems, such as protocols and procedures, were recognised as useful, but concerns were expressed about the quantity and currency of protocols and about the difficulties caused by lack of resource. Conclusion: We suggest that an understanding of how health professionals deal informally with ideas about safety and risk should be used to shape and enhance formal safety initiatives in health services as an important contribution to the development of person-centered clinical care.

Hospital patient safety situational analyses: Cameroon, Mali and Senegal

Hopitaux Universitaires de Geneve partners with hospitals in Cameroon, Mali & Senegal via African Partnerships for Patient Safety (APPS). Baseline hospital patient safety understanding is largely unknown in African settings. APPS is framed around 12 WHO AFRO action areas; prevention of health care-associated infection is a common platform.

A Multifaceted Approach to Safety

Objectives: Adverse drug event (ADE) detection is a national priority. This study compares results from 2 ADE detection systems, voluntary reporting and computerized surveillance, at a large academic medical center. We analyze the medications most likely to cause harm, evaluate each systems' strengths, and propose a synergistic strategy for medication safety. Methods: Adult, inpatient ADEs from a 7-month period were evaluated and scored using a standardized methodology. ADEs per 1,000 patient days were calculated. Results: Surveillance detected 710 ADEs (6.93/1000 patient days), whereas voluntary reporting identified 205 ADEs (1.96/1000 patient days). For each major drug category (anticoagulants, hypoglycemia, narcotics and benzodiazepines, and miscellaneous), surveillance and voluntary reporting detected significantly different event rates (P < 0.001). Most surveillance events were hypoglycemia-related (68.2%, 4.72/1000 patient days), whereas most voluntarily-reported events were in the miscellaneous category (49.8%, 0.98/1000 patient days). The 2 systems detected statistically different ADE rates when stratified by nursing station. Of all unique ADEs (875), only 40 (5.6%) were common between the systems. Conclusions: This study analyzes the results of 2 ADE detection systems used in daily hospital operations as well as a health system scorecard. Our aggregate analysis underscores the synergistic nature of these approaches. Although surveillance provides quantitative data to estimate the actual rate of ADEs, voluntary reporting contributes qualitative evidence to prompt future surveillance rule development and identify areas of emerging risk. In isolation, each system paints a partial picture, but together, they amplify our understanding of patient safety.