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International Journal For Quality in... Sep 2016To determine whether clinical supervision (CS) of health professionals improves patient safety. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To determine whether clinical supervision (CS) of health professionals improves patient safety.
DATA SOURCES
Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking.
STUDY SELECTION
Two reviewers independently applied inclusion and exclusion criteria. Thirty-two studies across three health professions [medicine (n = 29), nursing (n = 2) and paramedicine (n = 1)] were selected.
DATA EXTRACTION
The quality of each study was rated using the Medical Education Research Study Quality Instrument. Risk ratios (RR) were calculated for patient safety outcomes of mortality, complications, adverse events, reoperation following initial surgery, conversion to more invasive surgery and readmission to hospital.
RESULTS OF DATA SYNTHESIS
Results of meta-analyses provided low-quality evidence that supervision of medical professionals reduced the risk of mortality (RR 0.76, 95% CI 0.60-0.95, I(2) = 76%) and supervision of medical professionals and paramedics reduced the risk of complications (RR 0.69, 95% CI 0.53-0.89, I(2) = 76%). Due to a high level of statistical heterogeneity, sub-group analyses were performed. Sub-group analyses provided moderate-quality evidence that direct supervision of surgery significantly reduced the risk of mortality (RR 0.68, 95% CI 0.50-0.93, I(2) = 33%) and direct supervision of medical professionals conducting non-surgical invasive procedures significantly reduced the risk of complications (RR 0.33, 95% CI 0.24-0.46, I(2) = 0%).
CONCLUSIONS
CS was associated with safer surgery and other invasive procedures for medical practitioners. There was a lack of evidence about the relationship between CS and safer patient care for non-medical health professionals.
Topics: Health Personnel; Patient Safety; Quality Improvement
PubMed: 27283436
DOI: 10.1093/intqhc/mzw059 -
Enfermeria Clinica 2017
Topics: Ethnology; Health Equity; Humans; Patient Safety; Quality Improvement; Quality of Health Care
PubMed: 28684063
DOI: 10.1016/j.enfcli.2017.06.001 -
BMJ (Clinical Research Ed.) May 2017
Topics: Human Rights; Humans; Italy; Patient Safety
PubMed: 28533264
DOI: 10.1136/bmj.j2277 -
The Journal of Small Animal Practice Aug 2014
Topics: Animals; Humans; Patient Safety; Veterinary Medicine
PubMed: 25065423
DOI: 10.1111/jsap.12252 -
Revista Brasileira de Enfermagem 2018To measure the response time of health professionals before sound alarm activation and the implications for patient safety. (Observational Study)
Observational Study
OBJECTIVE
To measure the response time of health professionals before sound alarm activation and the implications for patient safety.
METHOD
This is a quantitative and observational research conducted in an Adult Intensive Care Unit of a teaching hospital. Three researchers conducted non-participant observations for seven hours. Data collection occurred simultaneously in 20 beds during the morning shift. When listening the alarm activation, the researchers turned on the stopwatches and recorded the motive, the response time and the professional conduct. During collection, the unit had 90% of beds occupied and teams were complete.
RESULT
We verified that from the 103 equipment activated, 66.03% of alarms fatigued. Nursing was the professional category that most provided care (31.06%) and the multi-parameter monitor was the device that alarmed the most (66.09%).
CONCLUSION
Results corroborate the absence or delay of the response of teams, suggesting that relevant alarms might have been underestimated, compromising patient safety.
Topics: Auditory Fatigue; Brazil; Clinical Alarms; Humans; Intensive Care Units; Length of Stay; Monitoring, Physiologic; Patient Safety; Time Factors
PubMed: 30517409
DOI: 10.1590/0034-7167-2017-0481 -
Clinical Pediatrics Jan 2018Children are particularly vulnerable to patient safety concerns due to pediatric-specific and general health care challenges. This scoping review identifies and... (Review)
Review
Children are particularly vulnerable to patient safety concerns due to pediatric-specific and general health care challenges. This scoping review identifies and describes the vulnerabilities of those aged 0 to 18 years to iatrogenic harm in various health care settings. Six databases were searched from 1991 to 2012. Primary studies were categorized using predetermined groupings. Categories were tallied and descriptive statistics were employed. A total of 388 primary studies exploring interventions that improved patient safety, deficiencies, or errors leading to safety concerns were included. The most common issues were medication (189 studies, 48.7%) and general medical (81 studies, 20.9%) errors. Sixty studies (15.5%) evaluated or described patient safety interventions, 206 studies (53.1%) addressed health care systems and technologies, 17 studies (4.4%) addressed caregiver perspectives and 20 studies (5.2%) discussed analytic models for patient safety. Further work is needed to ensure consistency of definitions in patient safety research to facilitate comparison and collation of results.
Topics: Adolescent; Child; Child, Preschool; Delivery of Health Care; Humans; Infant; Infant, Newborn; Patient Safety; Pediatrics
PubMed: 28952344
DOI: 10.1177/0009922817691820 -
Revista Brasileira de Enfermagem 2020to assess the patient safety culture of the health team working in three maternity hospitals. (Observational Study)
Observational Study
OBJECTIVES
to assess the patient safety culture of the health team working in three maternity hospitals.
METHODS
observational, cross-sectional, comparative study. 301 professionals participated in the study. The Hospital Survey on Patient Safety Culture questionnaire validated in Brazil was used. For data analysis, it was considered a strong area in the patient safety culture when positive responses reached over 75%; and areas that need improvement when positive responses have reached less than 50%. To compare the results, standard deviation and thumb rule were used.
RESULTS
of the 12 dimensions of patient safety culture, none obtained a score above 75%, with nine dimensions scoring between 19% and 43% and three dimensions between 55% and 57%.
CONCLUSIONS
no strong dimensions for safety culture were identified in the three maternity hospitals. It is believed that these results may contribute to the development of policies that promote a culture of safety in institutions.
Topics: Adult; Brazil; Cross-Sectional Studies; Female; Humans; Obstetrics and Gynecology Department, Hospital; Organizational Culture; Patient Safety; Safety Management; Surveys and Questionnaires
PubMed: 32667406
DOI: 10.1590/0034-7167-2019-0576 -
Drug Research Sep 2020There has been an escalation in the number, diversity, and complexity of medical devices. Regulation of these devices has also advanced due to the requirement of better...
There has been an escalation in the number, diversity, and complexity of medical devices. Regulation of these devices has also advanced due to the requirement of better regulatory perspective induced due to elevation in the number of adverse events associated with medical devices. All over the globe, various measures are undertaken to provide better safety to the patients along with attempts to improve the standard of medical devices. The initial and ultimate objective of the concept happens to be unfailingly to ensure patient safety as well as impart required guidance for both manufacturers and adept authorities enabling them to superintend cases coherently and appropriately. Materiovigilance programme of India (MvPI) was launched by the Drug Controller General of India at the Indian Pharmacopoeia commission (IPC) in Ghaziabad in 2015. The main purpose of this initiative is to monitor adverse events associated with medical devices in order to generate safety data, create awareness among the various stakeholders, and prescribe best practices for patient safety. Whilst the reforms in regulations have proposed policies and designs to elucidate, consolidate and accelerate the processes involved in manufacturing and importing medical devices to India, they consistently carry their challenges and limitations. To eliminate such complications the guidelines and regulations are anticipated to be implemented appropriately with the efficacious conclusion. India has been evident in matching with advancements in the World Medical Device regulation scenario, the current review at hand takes upon the question of 'how successful has it been so far'?
Topics: Equipment and Supplies; Humans; India; Patient Safety
PubMed: 32746478
DOI: 10.1055/a-1195-1945 -
BMJ Open Feb 2017To explore the status of patient safety culture in Arab countries based on the findings of the Hospital Survey on Patient Safety Culture (HSPSC). (Review)
Review
OBJECTIVES
To explore the status of patient safety culture in Arab countries based on the findings of the Hospital Survey on Patient Safety Culture (HSPSC).
DESIGN
Systematic review.
METHODS
We performed electronic searches of the MEDLINE, EMBASE, CINAHL, ProQuest and PsychINFO, Google Scholar and PubMed databases, with manual searches of bibliographies of included articles and key journals. We included studies that were conducted in the Arab countries that were focused on patient safety culture. 2 reviewers independently verified that the studies met the inclusion criteria and critically assessed the quality of the studies.
RESULTS
18 studies met our inclusion criteria. The review identified that non-punitive response to error is seen as a serious issue which needs to be improved. Healthcare professionals in the Arab countries tend to think that a 'culture of blame' still exists that prevents them from reporting incidents. We found an overall similarity between the reported composite score for dimension of teamwork within units in all of the reviewed studies. Teamwork within units was found to be better than teamwork across hospital units. All of the reviewed studies reported that organisational learning and continuous improvement was satisfactory as the average score of this dimension for all studies was 73.2%. Moreover, the review found that communication openness seems to be a concerning issue for healthcare professionals in the Arab countries.
CONCLUSIONS
There is a need to promote patient safety culture as a strategy for improving the patient safety in the Arab world. Improving patient safety culture should include all stakeholders, like policymakers, healthcare providers and those responsible for medical education. This review was limited only to English language publications. The varied settings in which the HSPSC was used may have influenced the areas of strengths and weaknesses as healthcare workers' perception of safety culture may differ.
Topics: Attitude of Health Personnel; Communication; Humans; Middle East; Organizational Culture; Patient Safety; Quality Improvement; Stakeholder Participation
PubMed: 28237956
DOI: 10.1136/bmjopen-2016-013487 -
PloS One 2020Various patient safety interventions have been implemented since the late 1990s, but their evaluation has been lacking. To obtain basic information for prioritizing...
Various patient safety interventions have been implemented since the late 1990s, but their evaluation has been lacking. To obtain basic information for prioritizing patient safety interventions, this study aimed to extract high-priority interventions in Japan and to identify the factors that influence the setting of priority. Six perspectives (contribution, dissemination, impact, cost, urgency, and priority) on 42 patient safety interventions classified into 3 levels (system, organizational, and clinical) were evaluated by Japanese experts using the Delphi technique. We examined the relationships of the levels and the perspectives on interventions with the transition of the consensus state in rounds 1 and 3. After extracting the high-priority interventions, a chi-squared test was used to examine the relationship of the levels and the impact/cost ratio with high priority. Regression models were used to examine the influence of each perspective on priority. There was a significant relationship between the level of interventions and the transition of the consensus state (p = 0.033). System-level interventions had a low probability of achieving consensus. "Human resources interventions," "professional education and training," "medication management/reconciliation protocols," "pay-for performance (P4P) schemes and financing for safety," "digital technology solutions to improve safety," and "hand hygiene initiatives" were extracted as high-priority interventions. The level and the impact/cost ratio of interventions had no significant relationships with high priority. In the regression model, dissemination and impact had an influence on priority (β = -0.628 and 0.941, respectively; adjusted R-squared = 0.646). The influence of impact and dissemination on the priority of interventions suggests that it is important to examine the dissemination degree and impact of interventions in each country for prioritizing interventions.
Topics: Cost-Benefit Analysis; Delphi Technique; Expert Testimony; Health Policy; Health Priorities; Japan; Patient Safety
PubMed: 32941481
DOI: 10.1371/journal.pone.0239179