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BMJ Open Quality Apr 2022Patient safety competencies in nursing are essential for the quality of healthcare. To develop practices and collaboration in nursing care, valid instruments that... (Review)
Review
BACKGROUND
Patient safety competencies in nursing are essential for the quality of healthcare. To develop practices and collaboration in nursing care, valid instruments that measure competencies in patient safety are needed.
OBJECTIVE
To identify instruments that measure the patient safety competencies of nurses.
DESIGN
A scoping review.
DATA SOURCES
The Cochran Library, Epistemonikos, Eric, Ovid Medline, CINAHL, Embase and Web of Science databases were searched for articles reporting on instruments measuring patient safety competence in nursing. The search was limited to English peer-reviewed scientific papers published from January 2010 to April 2021.
REVIEW METHOD
A blinded selection of articles fulfilling the inclusion criteria was performed by two researchers based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Data were then extracted, synthesised and presented in tables and text.
RESULTS
Our search identified 1,426 papers, of which 32 met the inclusion criteria. The selected papers described nine instruments, of which the '' was the most used instrument. The identified instruments comprised domains for patient safety skills, attitudes, knowledge, communication, teamwork and errors. The instruments had been tested for content (face) and construct validity as well as for reliability. However, sensitivity and responsiveness were rarely assessed.
CONCLUSIONS
Over the last decade, there has been a growing body of instruments aimed at measuring patient safety competencies among nurses. The future development of new instruments should consider including the important dimension of ethics in patient safety as well as evaluating the instrument's responsiveness to be able to track changes over time.
Topics: Humans; Patient Safety; Reproducibility of Results; Surveys and Questionnaires
PubMed: 35379672
DOI: 10.1136/bmjoq-2021-001751 -
Journal of Endourology Feb 2024The journey of minimally invasive (MI) urology is one of quality improvement (QI) and patient safety. New techniques have been progressively studied for adoption and... (Review)
Review
The journey of minimally invasive (MI) urology is one of quality improvement (QI) and patient safety. New techniques have been progressively studied for adoption and growth. As more advanced methods of data collection and analysis are developed, a review of the patterns and history of these principles in the development of MI urology can inform future urologic QI and patient safety initiatives. To perform a scoping review identifying patterns of QI and patient safety in MI urology. PubMed and the American Urological Association (AUA) journal search page were screened on December 2022 for publications using the search parameters "quality improvement" and "minimally invasive." Articles were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR). The initial literature search identified 471 articles from PubMed and 57 from the AUA journal search page. After screening, 528 articles were relevant to the topic and reviewed. Four hundred eighty-two articles were duplicates or did not meet inclusion criteria. Forty-six are included in this review. Urology has developed a pattern of assessing MI surgery the open counterpart. This includes analyzing the newest approach to understand complications, examining the factors contributing to complications, and lastly designing projects to mitigate future risk. This information, as well as advanced methods of data collection, has identified areas of improvement for new QI projects. The stage is set for a promising future with the adoption of advanced QI in daily urologic practice to improve patient safety and minimize errors.
Topics: Humans; Quality Improvement; Patient Safety; Urology; Minimally Invasive Surgical Procedures
PubMed: 37950717
DOI: 10.1089/end.2022.0733 -
Journal of Advanced Nursing Mar 2018To give an overview of empirical studies using self-reported instruments to assess patient safety culture in primary care and to synthesize psychometric properties of... (Review)
Review
AIMS
To give an overview of empirical studies using self-reported instruments to assess patient safety culture in primary care and to synthesize psychometric properties of these instruments.
BACKGROUND
A key condition for improving patient safety is creating a supportive safety culture to identify weaknesses and to develop improvement strategies so recurrence of incidents can be minimized. However, most tools to measure and strengthen safety culture have been developed and tested in hospitals. Nevertheless, primary care is facing greater risks and a greater likelihood of causing unintentional harm to patients.
DESIGN
A systematic literature review of research evidence and psychometric properties of self-reported instruments to assess patient safety culture in primary care.
DATA SOURCES
Three databases until November 2016.
REVIEW METHODS
The review was carried out according to the protocol for systematic reviews of measurement properties recommended by the COSMIN panel and the PRISMA reporting guidelines.
RESULTS
In total, 1.229 records were retrieved from multiple database searches (Medline = 865, Web of Science = 362 and Embase = 2). Resulting from an in-depth literature search, 14 published studies were identified, mostly originated from Western high-income countries. As these studies come with great diversity in tools used and outcomes reported, comparability of the results is compromised. Based on the psychometric review, the SCOPE-Primary Care survey was chosen as the most appropriate instrument to measure patient safety culture in primary care as the instrument had excellent internal consistency with Cronbach's alphas ranging from 0.70-0.90 and item factor loadings ranging from 0.40-0.96, indicating a good structural validity.
CONCLUSION
The findings of the present review suggest that the SCOPE-Primary Care survey is the most appropriate tool to assess patient safety culture in primary care. Further psychometric techniques are now essential to ensure that the instrument provides meaningful information regarding safety culture.
Topics: Empirical Research; Health Care Surveys; Humans; Organizational Culture; Patient Safety; Primary Health Care; Psychometrics; Self Report
PubMed: 28960472
DOI: 10.1111/jan.13464 -
Surgery Today Feb 2019In recent years, laparoscopic procedures have developed rapidly, and the reports of laparoscopic pancreatic resection including laparoscopic pancreaticoduodenectomy...
In recent years, laparoscopic procedures have developed rapidly, and the reports of laparoscopic pancreatic resection including laparoscopic pancreaticoduodenectomy (LPD) have increased in number. Although LPD is a complex procedure with high mortality, the training system for LPD remains unestablished. Ensuring patient safety is extremely important, even in challenging surgeries such a LPD. At present, several tools have been developed for surgical education to ensure patient safety preoperatively, such as video learning, virtual reality simulators, and cadaver training. Although LPD is reported as a safe and feasible choice, LPD is still a challenging operation. An LPD training system should be established with a board-certified system.
Topics: Cadaver; Clinical Competence; Education, Medical; Endoscopy, Digestive System; Humans; Imaging, Three-Dimensional; Laparoscopy; Multidetector Computed Tomography; Pancreaticoduodenectomy; Patient Safety; Printing, Three-Dimensional; Teaching Materials; Video Recording
PubMed: 29748825
DOI: 10.1007/s00595-018-1668-1 -
International Journal of Environmental... Nov 2022Patient safety in long-term care is becoming an increasingly popular subject in the scientific literature. Organizational problems such as shortages of medical staff,... (Review)
Review
INTRODUCTION
Patient safety in long-term care is becoming an increasingly popular subject in the scientific literature. Organizational problems such as shortages of medical staff, insufficient numbers of facilities or underfunding increase the risk of adverse events, and aging populations in many countries suggests that these problems will become more and more serious with each passing year. The objective of the study is to identify interventions that can contribute to increasing patient safety in long-term care facilities.
METHOD
A systematic review of secondary studies was conducted in accordance with the Cochrane Collaboration guidelines. Searches were conducted in Medline (via PubMed), Embase (via OVID) and Cochrane Library. The quality of the included studies was assessed using AMSTAR2.
RESULTS
Ultimately, 10 studies were included in the analysis. They concerned three main areas: promoting safety culture, reducing the level of occupational stress and burnout, and increasing the safety of medication use. Promising methods that have an impact on increasing patient safety include: preventing occupational burnout of medical staff, e.g., by using mindfulness-based interventions; preventing incidents resulting from improper administration of medications, e.g., by using structured methods of patient transfer; and the use of information technology that is more effective than the classic (paper) method or preventing nosocomial infections, e.g., through programs to improve the quality of care in institutions and the implementation of an effective infection control system.
CONCLUSIONS
Taking into account the scientific evidence found and the guidelines of institutions dealing with patient safety, it is necessary for each long-term care facility to individually implement interventions aimed at continuous improvement of the quality of care and patient safety culture at the level of medical staff and management staff.
Topics: Humans; Patient Safety; Long-Term Care; Skilled Nursing Facilities; Nursing Homes; Safety Management; Burnout, Professional
PubMed: 36430073
DOI: 10.3390/ijerph192215354 -
Journal of Evidence-based Medicine May 2017To identify and qualitatively describe, in a literature review, how the instruments were used to evaluate patient safety culture in the operating rooms of published... (Review)
Review
OBJECTIVE
To identify and qualitatively describe, in a literature review, how the instruments were used to evaluate patient safety culture in the operating rooms of published studies.
METHODS
Systematic searches of the literature were conducted using the major database including MEDLINE, EMbase, The Cochrane Library, and four Chinese databases including Chinese Biomedical Literature Database (CBM), Wanfang Data, Chinese Scientific Journal Database (VIP), and Chinese Journals Full-text Database (CNKI) for studies published up to March 2016. We summarized and analyzed the country scope, the instrument utilized in the study, the year when the instrument was used, and fields of operating rooms. Study populations, study settings, and the time span between baseline and follow-up phase were evaluated according to the study design.
RESULTS
We identified 1025 references, of which 99 were obtained for full-text assessment; 47 of these studies were deemed relevant and included in the literature review. Most of the studies were from the USA. The most commonly used patient safety culture instrument was Safety Attitude Questionnaire. All identified instruments were used after 2002 and across many fields. Most included studies on patient safety culture were conducted in teaching hospitals or university hospitals. The study population in the cross-sectional studies was much more than that in the before-after studies. The time span between baseline and follow-up phase of before-after studies were almost over three months.
CONCLUSION
Although patient safety culture is considered important in health care and patient safety, the number of studies in which patient safety culture has been estimated using the instruments in operating rooms, is fairly small.
Topics: Cross-Sectional Studies; Hospitals, Teaching; Hospitals, University; Humans; Operating Rooms; Organizational Culture; Patient Safety; Research Design; Safety Management
PubMed: 28471047
DOI: 10.1111/jebm.12255 -
BMC Family Practice Jun 2018Patient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation...
BACKGROUND
Patient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety measures used globally to inform the development of safety culture among health care workers in primary care with a particular focus on the Middle East.
METHODS
A systematic review of the literature. Searches were undertaken using Medline, EMBASE, CINAHL and Scopus from the year 2000 to 2014. Terms defining safety culture were combined with terms identifying patient safety and primary care.
RESULTS
The database searches identified 3072 papers that were screened for inclusion in the review. After the screening and verification, data were extracted from 28 papers that described safety culture in primary care. The global distribution of the articles is as follows: the Netherlands (7), the United States (5), Germany (4), the United Kingdom (1), Australia, Canada and Brazil (two for each country), and with one each from Turkey, Iran, Saudi Arabia and Kuwait. The characteristics of the included studies were grouped under the following themes: safety culture in primary care, incident reporting, safety climate and adverse events. The most common theme from 2011 onwards was the assessment of safety culture in primary care (13 studies, 46%). The most commonly used safety culture assessment tool is the Hospital survey on patient safety culture (HSOPSC) which has been used in developing countries in the Middle East.
CONCLUSIONS
This systematic review reveals that the most important first step is the assessment of safety culture in primary care which will provide a basic understanding to safety-related perceptions of health care providers. The HSOPSC has been commonly used in Kuwait, Turkey, and Iran.
Topics: Humans; Middle East; Organizational Culture; Patient Safety; Primary Health Care; Safety Management
PubMed: 29960590
DOI: 10.1186/s12875-018-0793-7 -
Curationis Apr 2016Herbal and homeopathic remedies have been used to assist with child bearing and pregnancy for centuries. Allopathic ('Western') medicine is traditionally avoided during... (Review)
Review
BACKGROUND
Herbal and homeopathic remedies have been used to assist with child bearing and pregnancy for centuries. Allopathic ('Western') medicine is traditionally avoided during pregnancy because of limited drug trials and the suspected teratogenic effects of these medications. This has led to an increase in the use of herbal and homeopathic remedies, asthey are viewed to have no teratogenic effect on the developing foetus. Health providers are faced with questions from their clients regarding the safety of these remedies, but much of the evidence about these herbal and homeopathic remedies is anecdotal and few remedies havebeen tested scientifically.
OBJECTIVES
By conducting a systematic review, the primary objective was to evaluate maternal and neonatal outcomes of ingested herbal and homeopathic remedies during pregnancy.
METHOD
A systematic review was conducted to synthesise all the evidence with the purpose of evaluating the safety of herbal and homeopathic remedies based on adverse maternal and neonatal outcomes. Only randomised and quasi-randomised controlled trials that met allinclusion criteria were included in the review.
RESULTS
The ingestion of ginger for nausea and vomiting during pregnancy was shown to have no harmful maternal or neonatal effects. Ingestion of castor oil for induction of labour showed a tendency towards an increase in the incidence of caesarean section and meconiumstained liquor, warranting further research into its safety issues.
CONCLUSION
Larger randomised controlled trials need to be conducted, especially in South Africa, to establish the safety and efficacy of commonly-used remedies.
Topics: Female; Homeopathy; Humans; Patient Safety; Phytotherapy; Plant Preparations; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prenatal Care
PubMed: 27246791
DOI: 10.4102/curationis.v39i1.1514 -
Health Policy (Amsterdam, Netherlands) May 2024Pay-for-performance (p4p) has been tried in all healthcare settings to address ongoing deficiencies in the quality and outcomes of care. The evidence for the effect of... (Review)
Review
Pay-for-performance (p4p) has been tried in all healthcare settings to address ongoing deficiencies in the quality and outcomes of care. The evidence for the effect of these policies has been inconclusive, especially in acute care. This systematic review focused on patient safety p4p in the hospital setting. Using the PRISMA guidelines, we searched five biomedical databases for quantitative studies using at least one outcome metric from database inception to March 2023, supplemented by reference tracking and internet searches. We identified 6,122 potential titles of which 53 were included: 39 original investigations, eight literature reviews and six grey literature reports. Only five system-wide p4p policies have been implemented, and the quality of evidence was low overall. Just over half of the studies (52 %) included failed to observe improvement in outcomes, with positive findings heavily skewed towards poor quality evaluations. The exception was the Fragility Hip Fracture Best Practice Tariff (BPT) in England, where sustained improvement was observed across various evaluations. All policies had a miniscule impact on total hospital revenue. Our findings underscore the importance of simple and transparent design, involvement of the clinical community, explicit links to other quality improvement initiatives, and gradual implementation of p4p initatives. We also propose a research agenda to lift the quality of evidence in this field.
Topics: Humans; Reimbursement, Incentive; Patient Safety; Quality Improvement; Delivery of Health Care; Hospitals
PubMed: 38547664
DOI: 10.1016/j.healthpol.2024.105051 -
Clinical Pediatrics Sep 2014Pediatric obesity affects more than 16% of American children and is associated with worse outcomes in hospitalized patients. A systematic literature review was performed... (Review)
Review
OBJECTIVE
Pediatric obesity affects more than 16% of American children and is associated with worse outcomes in hospitalized patients. A systematic literature review was performed to identify studies of adverse care events affecting obese pediatric patients in the emergency room, operating room, or inpatient wards.
EVIDENCE REVIEW
We systematically searched Medline for articles published from 1970 to 2013 regarding obesity and patient safety events in pediatric acute care settings. We determined the study design, number of patients studied, definition and prevalence of obesity, the relevant acute care setting, the specific association with obesity addressed, and the results of each study.
RESULTS AND CONCLUSION
Thirty-four studies documented both procedural complications and issues with general hospital care. Most were retrospective and focused on surgery or anesthesia. Obese patients may have increased risk for a variety of adverse events. Further study could improve institutional patient safety guidelines to enhance care for obese children.
Topics: Body Mass Index; Child; Emergency Service, Hospital; Evidence-Based Medicine; Humans; Inpatients; Operating Rooms; Patient Safety; Patients' Rooms; Pediatric Obesity; Prevalence; Risk Assessment; Risk Factors; Tertiary Care Centers; United States
PubMed: 24803638
DOI: 10.1177/0009922814533406