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Journal of Patient Safety Mar 2021The aim of the study was to review reported falls in critical care units to see whether the causes and results were different from those described in a general hospital...
AIM
The aim of the study was to review reported falls in critical care units to see whether the causes and results were different from those described in a general hospital population.
METHODS
We reviewed and classified patient safety incidents describing falls from critical care units in the North West of England between 2009 and 2017. The classification reviewed patient and staff factors contributing to the fall, the environment of the fall, and the reported consequences. We then calculated and compared rates of falls in different units.
RESULTS
There were 914 falls reported, representing only 2.0% of all reported incidents. The median (interquartile range) unit rate was 1.0 falls per 1000 (0.5-1.2) days, and falls were unrelated to the number of single rooms and were no more common in specialist units. There were 304 (33%) falls in patients transferring (207 to standing, 8 from standing), and there were 259 (28%) falls from bed. Patient factors included attempting tasks without assistance (323 incidents [35%]) and organic confusion (188 incidents [21%]). Staff factors included being away from the patient (375 incidents [41%]). Harm was described in 201 incidents (22%), including removal of medical devices (40 incidents), injury to staff (10 incidents) subdural hematoma, and possible spinal injury (1 incident each).
CONCLUSIONS
There is a low rate of falls and associated harm in critical care units. The variation between units suggests that this rate could be further reduced by the prevention and management of delirium and by educating patients and staff to take care when moving patients to the standing position.
Topics: Accidental Falls; Critical Care; England; Female; History, 21st Century; Humans; Male; Patient Safety
PubMed: 30747859
DOI: 10.1097/PTS.0000000000000574 -
Anaesthesia Nov 2021
Topics: Disaster Planning; Fires; Guidelines as Topic; Intensive Care Units; Patient Safety; Rescue Work; Safety Management
PubMed: 34309007
DOI: 10.1111/anae.15547 -
Journal of Nursing Management Apr 2020We employed the job demands-resources model to examine the impacts of job demands and resources on Chinese nurses' mental health and patient safety.
AIM
We employed the job demands-resources model to examine the impacts of job demands and resources on Chinese nurses' mental health and patient safety.
BACKGROUND
Employee mental health and patient safety represent important organisational goals in most hospitals. However, their relationships to insomnia, professional resources and job crafting, as related to the job demands-resources model among nurses, remain unclear.
METHODS
A convenience sample of 2095 registered hospital nurses was recruited from 25 provinces of mainland China from June 2019 to July 2019. Data were collected using self-reported questionnaires that included the following instruments: the Chinese version of the Athens Insomnia Scale, the Practice Environment Scale of the Nursing Work Index, the Job Crafting Scale, the Emotional Exhaustion Scale, the Utrecht Work Engagement Scale, the General Health Questionnaire and the Safety Attitudes Questionnaire.
RESULTS
The final model confirmed our hypotheses: burnout mediated the relationship between actual job demands and mental health; work engagement mediated the relationship between perceived job resources and attitudes with regard to patient safety; and job crafting enhanced work engagement and practice environment.
CONCLUSION
The job demands-resources model was extended based on the nurses' job characteristics and mental health, as well as patient safety.
IMPLICATIONS FOR NURSING MANAGEMENT
These findings may contribute to nursing management strategies that encourage employees to prevent burnout, promote work engagement and job crafting, and in turn promote nurses' mental health and patient safety.
Topics: Adult; Attitude of Health Personnel; Burnout, Professional; China; Female; Health Resources; Humans; Job Satisfaction; Male; Nurses; Patient Safety; Surveys and Questionnaires; Workload; Workplace
PubMed: 32052511
DOI: 10.1111/jonm.12971 -
Journal of Advanced Nursing Jan 2020To obtain a comprehensive insight of the impact of patient and family engagement on patient safety and identify issues in implementing this approach.
AIMS
To obtain a comprehensive insight of the impact of patient and family engagement on patient safety and identify issues in implementing this approach.
BACKGROUND
Patient and family engagement is increasingly emerging as a potential approach for improving patient safety.
DESIGN
Mixed method multilevel synthesis.
DATA SOURCES
PubMed, CINAHL, Embase, and Cochrance Library (January 2009-April 2018).
REVIEW METHODS
The review was conducted according to the principles recommended by the Cochrane Handbook for Systematic Review and in accordance with the PRISMA guidelines.
RESULTS
Forty-two relevant studies were identified. Common intervention groups included 'direct care' and 'organization' levels with 'consultation' and 'involvement' approaches, while the 'health system' level and 'partnership and shared leadership' approaches were rarely implemented. Findings revealed positive effects of the interventions on patient safety. Most study participants expressed their willingness to engage in or support patient and family engagement. However, existing gaps and barriers in implementing patient and family engagement were identified.
CONCLUSION
Future research should further focus on issuing consensus guidelines for implementing patient and family engagement in patient safety, extending the research scope for all aspects of patient and family engagement and patient safety and identifying priority areas for action that is suitable for each health facility.
IMPACT
Policymakers should issue guidelines for implementing patient and family engagement in healthcare systems which would enable healthcare providers to implement patient and family engagement and improve patient safety appropriately and effectively.
Topics: Family; Female; Humans; Male; Patient Safety; Patients
PubMed: 31588602
DOI: 10.1111/jan.14227 -
Journal of Clinical Monitoring and... Feb 2022
Topics: Humans; Patient Safety; Wearable Electronic Devices
PubMed: 34665392
DOI: 10.1007/s10877-021-00767-0 -
Journal of Patient Safety Sep 2020Major gaps remain in our understanding of primary care patient safety. We describe a toolkit for measuring patient safety in family practices.
OBJECTIVE
Major gaps remain in our understanding of primary care patient safety. We describe a toolkit for measuring patient safety in family practices.
METHODS
Six tools were used in 46 practices. These tools were as follows: National Health Service Education for Scotland Trigger Tool, National Health Service Education for Scotland Medicines Reconciliation Tool, Primary Care Safequest, Prescribing Safety Indicators, Patient Reported Experiences and Outcomes of Safety in Primary Care, and Concise Safe Systems Checklist.
RESULTS
Primary Care Safequest showed that most practices had a well-developed safety climate. However, the trigger tool revealed that a quarter of events identified were associated with moderate or substantial harm, with a third originating in primary care and avoidable. Although medicines reconciliation was undertaken within 2 days in more than 70% of cases, necessary discussions with a patient/carer did not always occur. The prescribing safety indicators identified 1435 instances of potentially hazardous prescribing or lack of recommended monitoring (from 92,649 patients). The Concise Safe Systems Checklist found that 25% of staff thought that their practice provided inadequate follow-up for vulnerable patients discharged from hospital and inadequate monitoring of noncollection of prescriptions. Most patients had a positive perception of the safety of their practice although 45% identified at least one safety problem in the past year.
CONCLUSIONS
Patient safety is complex and multidimensional. The Patient Safety Toolkit is easy to use and hosted on a single platform with a collection of tools generating practical and actionable information. It enables family practices to identify safety deficits that they can review and change procedures to improve their patient safety across a key sets of patient safety issues.
Topics: Family Practice; Female; Humans; Male; Patient Safety; Primary Health Care
PubMed: 29461334
DOI: 10.1097/PTS.0000000000000471 -
Clinics in Plastic Surgery Oct 2023Gluteal augmentation is a quickly evolving field that continues to grow in the realms of patient safety, surgical education, and technological advancement. This article... (Review)
Review
Gluteal augmentation is a quickly evolving field that continues to grow in the realms of patient safety, surgical education, and technological advancement. This article discusses innovation in gluteal augmentation and suggests potential new pathways for developing the practice of gluteal augmentation.
Topics: Humans; Patient Safety; Plastic Surgery Procedures
PubMed: 37704329
DOI: 10.1016/j.cps.2023.06.009 -
Annals of Surgery Jan 2020
Review
Topics: Delivery of Health Care; Goals; Humans; Motivation; Organizational Culture; Patient Safety; Quality of Health Care
PubMed: 30973390
DOI: 10.1097/SLA.0000000000003316 -
Family Practice Management Mar 2023
Topics: Humans; Patient Safety; Primary Health Care
PubMed: 36917724
DOI: No ID Found -
BMC Health Services Research Nov 2019Patient safety is a key target in public health, health services and medicine. Communication between all parties involved in gynecology and obstetrics (clinical...
BACKGROUND
Patient safety is a key target in public health, health services and medicine. Communication between all parties involved in gynecology and obstetrics (clinical staff/professionals, expectant mothers/patients and their partners, close relatives or friends providing social support) should be improved to ensure patient safety, including the avoidance of preventable adverse events (pAEs). Therefore, interventions including an app will be developed in this project through a participatory approach integrating two theoretical models. The interventions will be designed to support participants in their communication with each other and to overcome difficulties in everyday hospital life. The aim is to foster effective communication in order to reduce the frequency of pAEs. If communication is improved, clinical staff should show an increase in work satisfaction and patients should show an increase in patient satisfaction.
METHODS
The study will take place in two maternity clinics in Germany. In line with previous studies of complex interventions, it is divided into three interdependent phases. Each phase provides its own methods and data. Phase 1: Needs assessment and a training for staff (n = 140) tested in a pre-experimental study with a pre/post-design. Phase 2: Assessment of communication training for patients and their social support providers (n = 423) in a randomized controlled study. Phase 3: Assessment of an app supporting the communication between staff, patients, and their social support providers (n = 423) in a case-control study. The primary outcome is improvement of communication competencies. A range of other implementation outcomes will also be assessed (i.e. pAEs, patient/treatment satisfaction, work satisfaction, safety culture, training-related outcomes).
DISCUSSION
This is the first large intervention study on communication and patient safety in gynecology and obstetrics integrating two theoretical models that have not been applied to this setting. It is expected that the interventions, including the app, will improve communication practice which is linked to a lower probability of pAEs. The app will offer an effective and inexpensive way to promote effective communication independent of users' motivation. Insights gained from this study can inform other patient safety interventions and health policy developments.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT03855735; date of registration: February 27, 2019.
Topics: Clinical Protocols; Communication; Female; Gynecology; Health Care Surveys; Humans; Obstetrics; Patient Safety; Patient Satisfaction; Pregnancy
PubMed: 31779620
DOI: 10.1186/s12913-019-4579-y