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Revista Brasileira de Enfermagem 2020to identify the patient safety challenges described by health professionals in Primary Health Care. (Review)
Review
OBJECTIVES
to identify the patient safety challenges described by health professionals in Primary Health Care.
METHODS
a scoping review was conducted on the LILACS, MEDLINE, IBECS, BDENF, and CINAHL databases, and on the Cochrane, SciELO, Pubmed, and Web of Science libraries in January 2019. Original articles on patient safety in the context of Primary Health Care by health professionals were included.
RESULTS
the review included 26 studies published between 2002 and 2019. Four categories resulted from the analysis: challenges of health professionals, administration challenges of health services, challenges with the patient and family, and the potential enhancing resources for patient safety.
CONCLUSIONS
patient safety challenges for Primary Care professionals are multiple and complex. This study provides insight into resources to improve patient safety for health care professionals, patients, administrators, policy makers, educators, and researchers.
Topics: Humans; Patient Safety; Primary Health Care; Safety Management
PubMed: 32638932
DOI: 10.1590/0034-7167-2019-0209 -
Medicina Clinica May 2017
Topics: Humans; Organizational Culture; Patient Safety; Safety Management
PubMed: 28073511
DOI: 10.1016/j.medcli.2016.12.008 -
Western Journal of Nursing Research May 2020Presenteeism is linked to negative outcomes for patients, nurses, and health care organizations; however, we lack understanding of the relationships between nurse...
Presenteeism is linked to negative outcomes for patients, nurses, and health care organizations; however, we lack understanding of the relationships between nurse fatigue, burnout, psychological well-being, team vitality, presenteeism, and patient safety in nursing. Therefore, the two aims of this study were: (a) to examine the fit of a literature-derived model of the relationships between presenteeism, psychological health and well-being, fatigue, burnout, team vitality, and patient safety; and (b) to examine the role of presenteeism as a mediator between patient safety and the other model variables. Survey data were analyzed using Composite Indicator Structural Equation (CISE) modeling, a type of structural equation modeling. Model fit was acceptable with multiple significant relationships. Presenteeism due to job-stress mediated multiple relationships to patient safety. Our findings indicate that focusing on job-stress presenteeism may be relevant for this population and may offer additional insight into factors contributing to decreased nurse performance and the resulting risks to patient safety.
Topics: Adult; Cross-Sectional Studies; Female; Health Status; Humans; Job Satisfaction; Male; Middle Aged; Nurses; Patient Safety; Presenteeism; Surveys and Questionnaires; Workplace
PubMed: 31296124
DOI: 10.1177/0193945919863409 -
International Journal of Nursing Studies Feb 2016A language barrier has been shown to be a threat for quality of hospital care. International studies highlighted a lack of adequate noticing, reporting, and bridging of...
INTRODUCTION
A language barrier has been shown to be a threat for quality of hospital care. International studies highlighted a lack of adequate noticing, reporting, and bridging of a language barrier. However, studies on the link between language proficiency and patient safety are scarce, especially in Europe. The present study investigates patient safety risks due to language barriers during hospitalization, and the way language barriers are detected, reported, and bridged in Dutch hospital care.
METHODS
We combined quantitative and qualitative methods in a sample of 576 ethnic minority patients who were hospitalized on 30 wards within four urban hospitals. The nursing and medical records of 17 hospital admissions of patients with language barriers were qualitatively analyzed, and complemented by 12 in-depth interviews with care providers and patients and/or their relatives to identify patient safety risks during hospitalization. The medical records of all 576 patients were screened for language barrier reports. The results were compared to patients' self-reported Dutch language proficiency. The policies of wards regarding bridging language barriers were compared with the reported use of interpreters in the medical records.
RESULTS
Situations in hospital care where a language barrier threatened patient safety included daily nursing tasks (i.e. medication administration, pain management, fluid balance management) and patient-physician interaction concerning diagnosis, risk communication and acute situations. In 30% of the patients that reported a low Dutch proficiency, no language barrier was documented in the patient record. Relatives of patients often functioned as interpreter for them and professional interpreters were hardly used.
DISCUSSION
The present study showed a wide variety of risky situations in hospital care for patients with language barriers. These risks can be reduced by adequately bridging the language barrier, which, in the first place, demands adequate detecting and reporting of a language barrier. This is currently not sufficiently done in most Dutch hospitals. Moreover, new solutions to bridge language barriers are needed for situations such as routine safety checks performed by nurses, in which a professional or even informal interpreter is not feasible.
Topics: Communication Barriers; Hospitalization; Netherlands; Patient Safety; Quality of Health Care
PubMed: 25840899
DOI: 10.1016/j.ijnurstu.2015.03.012 -
BMC Health Services Research Jul 2018Adverse events (AEs) seriously affect patient safety and quality of care, and remain a pressing global issue. This study had three objectives: (1) to describe the... (Review)
Review
BACKGROUND
Adverse events (AEs) seriously affect patient safety and quality of care, and remain a pressing global issue. This study had three objectives: (1) to describe the proportions of patients affected by in-hospital AEs; (2) to explore the types and consequences of observed AEs; and (3) to estimate the preventability of in-hospital AEs.
METHODS
We applied a scoping review method and concluded a comprehensive literature search in PubMed and CINAHL in May 2017 and in February 2018. Our target was retrospective medical record review studies applying the Harvard method-or similar methods using screening criteria-conducted in acute care hospital settings on adult patients (≥18 years).
RESULTS
We included a total of 25 studies conducted in 27 countries across six continents. Overall, a median of 10% patients were affected by at least one AE (range: 2.9-21.9%), with a median of 7.3% (range: 0.6-30%) of AEs being fatal. Between 34.3 and 83% of AEs were considered preventable (median: 51.2%). The three most common types of AEs reported in the included studies were operative/surgical related, medication or drug/fluid related, and healthcare-associated infections.
CONCLUSIONS
Evidence regarding the occurrence of AEs confirms earlier estimates that a tenth of inpatient stays include adverse events, half of which are preventable. However, the incidence of in-hospital AEs varied considerably across studies, indicating methodological and contextual variations regarding this type of retrospective chart review across health care systems. For the future, automated methods for identifying AE using electronic health records have the potential to overcome various methodological issues and biases related to retrospective medical record review studies and to provide accurate data on their occurrence.
Topics: Cross Infection; Data Accuracy; Data Collection; Electronic Health Records; Hospitalization; Hospitals; Humans; Incidence; Medical Errors; Patient Safety; Retrospective Studies
PubMed: 29973258
DOI: 10.1186/s12913-018-3335-z -
BMJ Open Quality Feb 2020Open communication between leadership and frontline staff at the unit level is vital in promoting safe hospital culture. Our hospital staff culture survey identified the...
BACKGROUND
Open communication between leadership and frontline staff at the unit level is vital in promoting safe hospital culture. Our hospital staff culture survey identified the failure to address safety issues as one of the areas where staff felt unable to express their concerns openly. Thus, this improvement project using the daily safety huddle tool has been developed to enhance teamwork communication and respond effectively to patient safety issues identified in a paediatric intensive care unit.
METHODS
We used the TeamSTEPPS quality approach. TeamSTEPPS is an evidence-based set of teamwork tools developed by the US Agency of Healthcare Research and Quality to enhance teamwork and communication. We applied TeamSTEPPS using a tool called the Daily Safety Huddle, aiming at improving communication and interaction between healthcare workers and building trust by acting immediately when there is any patient safety issue or concern at the unit level.
RESULTS
During the period from April to December 2017, the interaction between frontline staff and unit leadership increased through compliance with the daily safety huddle. Initially, compliance was at 73%, but it increased to 97%, with a total of 340 safety issues addressed. The majority of these safety issues pertained to infection control and medication errors (109; 32.05%), followed by communication (83; 24.41%), documentation (59; 17.35%), other issues (37; 10.88%), procedure (20; 5.88%), patient flow (16; 4.7%) and equipment and supplies (16; 4.7%).
CONCLUSIONS
Systematic use of daily safety huddle is a powerful tool to create an equitable environment where frontline staff can speak up freely about daily patient safety concerns. The huddle leads to a more open and active discussion with unit leadership and to the ability to perform the right action at the right time.
Topics: Communication; Humans; Intensive Care Units, Pediatric; Patient Care Team; Patient Safety; Quality Improvement; State Medicine; Surveys and Questionnaires
PubMed: 32098776
DOI: 10.1136/bmjoq-2019-000753 -
BMJ (Clinical Research Ed.) Oct 2018
Topics: Female; Humans; Patient Safety; Pelvic Organ Prolapse; Registries; Surgical Mesh; Urinary Incontinence, Stress
PubMed: 30305286
DOI: 10.1136/bmj.k4231 -
Clinics in Laboratory Medicine Jun 2019In recent years, clinical decision support (CDS) systems have become recognized as increasingly important in assuring patient safety and supporting all phases of the... (Review)
Review
In recent years, clinical decision support (CDS) systems have become recognized as increasingly important in assuring patient safety and supporting all phases of the clinical decision-making process. In Laboratory Medicine, CDS systems are usually used to drive test ordering and diagnostic prediction while combining IT components and staff skills. However, educational initiatives, user and provider feedback, and expert consultations should also be considered integral to CDS. The aim of this paper is to provide an overview of some important developments in CDS in supporting the clinical decision-making process and guaranteeing patient safety by reducing medical errors.
Topics: Decision Making; Decision Support Systems, Clinical; Decision Support Techniques; Electronic Health Records; Humans; Laboratories; Patient Safety
PubMed: 31036277
DOI: 10.1016/j.cll.2019.01.003 -
Annals of Surgery May 2018
Review
Topics: Education, Medical, Graduate; Humans; Internship and Residency; Patient Safety; Training Support
PubMed: 29166357
DOI: 10.1097/SLA.0000000000002599 -
Journal of Neuro-ophthalmology : the... Sep 2017
Topics: History, 20th Century; History, 21st Century; Humans; Neurology; Ophthalmology; Patient Safety
PubMed: 28806313
DOI: 10.1097/WNO.0000000000000559