-
Annals of Internal Medicine Mar 2013Developing a culture of safety is a core element of many efforts to improve patient safety and care quality. This systematic review identifies and assesses interventions... (Review)
Review
Developing a culture of safety is a core element of many efforts to improve patient safety and care quality. This systematic review identifies and assesses interventions used to promote safety culture or climate in acute care settings. The authors searched MEDLINE, CINAHL, PsycINFO, Cochrane, and EMBASE to identify relevant English-language studies published from January 2000 to October 2012. They selected studies that targeted health care workers practicing in inpatient settings and included data about change in patient safety culture or climate after a targeted intervention. Two raters independently screened 3679 abstracts (which yielded 33 eligible studies in 35 articles), extracted study data, and rated study quality and strength of evidence. Eight studies included executive walk rounds or interdisciplinary rounds; 8 evaluated multicomponent, unit-based interventions; and 20 included team training or communication initiatives. Twenty-nine studies reported some improvement in safety culture or patient outcomes, but measured outcomes were highly heterogeneous. Strength of evidence was low, and most studies were pre-post evaluations of low to moderate quality. Within these limits, evidence suggests that interventions can improve perceptions of safety culture and potentially reduce patient harm.
Topics: Hospital Costs; Hospitals; Humans; Interdisciplinary Communication; Organizational Culture; Outcome Assessment, Health Care; Patient Care Team; Patient Safety; Personnel, Hospital; Safety Management
PubMed: 23460092
DOI: 10.7326/0003-4819-158-5-201303051-00002 -
Medicina Clinica May 2017
Topics: Humans; Organizational Culture; Patient Safety; Safety Management
PubMed: 28073511
DOI: 10.1016/j.medcli.2016.12.008 -
BMJ Quality & Safety Jan 2013To determine the effectiveness of patient safety culture strategies to improve hospital patient safety climate. (Review)
Review
PURPOSE
To determine the effectiveness of patient safety culture strategies to improve hospital patient safety climate.
DATA SOURCES
Electronic search of the Cochrane Library, OVID Medline, Embase, CINAHL, proQuest and psychinfo databases, with manual searches of quality and safety websites, bibliographies of included articles and key journals.
STUDY SELECTION
English language studies published between January 1996 and April 2011 that measured the effectiveness of patient safety culture strategies using a quantitative measure of patient safety climate in a hospital setting. Studies included were randomised controlled trials (RCTs), non-RCTs, controlled before and after studies, interrupted time series and historically controlled studies.
DATA EXTRACTION
Data extraction and critical appraisal were conducted by two independent reviewers. Study design, intervention, level of application, setting, study participants, safety climate outcome measures and implementation lessons were extracted from each article.
RESULTS OF DATA SYNTHESIS
Over 2000 articles were screened, with 21 studies meeting the inclusion criteria, one cluster RCT, seven controlled before and after studies, and 13 historically controlled studies. There was marked methodological heterogeneity amongst studies. Impacts of 11 different strategies were reported. There was some evidence to support that leadership walk rounds (p=0.02) and multi-faceted unit-based programmes (p < 0.05) may have a positive impact on patient safety climate.
CONCLUSIONS
Despite strong face validity for a variety of patient safety culture strategies, there is limited evidence to support definitive impacts on patient safety climate outcomes. Organisations are advised to consider robust evaluation designs when implementing these potentially resource intensive strategies.
Topics: Humans; Organizational Culture; Patient Safety; Quality Improvement
PubMed: 22849965
DOI: 10.1136/bmjqs-2011-000582 -
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 -
Clinical & Translational Oncology :... May 2020The Working Group on Patient Safety and Quality of the Spanish Society of Radiation Oncology, revised the most relevant national and international recommendations,... (Review)
Review
PURPOSE
The Working Group on Patient Safety and Quality of the Spanish Society of Radiation Oncology, revised the most relevant national and international recommendations, selecting a series of important aspects for patient safety, evaluating whether they are included in Spanish legislation MATERIALS AND METHODS: We have considered a concept as relevant to the patient safety in radiotherapy if so defined in at least 8 of the 16 documents reviewed.
RESULTS
12 subjects were selected: training and qualification, human resources, protocols, safety culture, communication, peer review, accreditation: audits, checklists, areas without interruptions, maps of processes and risks, prospective risk analysis, notification, registration and incident learning, and quality control of the equipment.
CONCLUSIONS
At the legislative level, as well as the professional organizations and the health center directorates, the implementation of safety culture must continue to be fostered. Only in this environment will the tools and measures to increase patient safety be effective. The current Spanish legislation must be revised and updated, in accordance with directive 2013/59/EURATOM and the Patient Safety Strategy 2015-2020 of the Spanish National Health System, introducing the obligation to perform risk analysis and incidents management. Audits and accreditations must be carried out, thus raising the general level of practice of the specialty. In this process, the Spanish Society of Radiation Oncology must continue playing its fundamental role, collaborating with the institutions and the rest of the scientific societies involved in the radiotherapy process, issuing recommendations on patient safety and disseminating the safety culture in our specialty.
Topics: Humans; Neoplasms; Patient Safety; Practice Guidelines as Topic; Radiation Oncology; Spain
PubMed: 31325036
DOI: 10.1007/s12094-019-02184-x -
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 -
Healthcare Quarterly (Toronto, Ont.) 2013
Topics: Humans; Patient Safety; Quality of Health Care
PubMed: 24485234
DOI: No ID Found -
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 -
Lancet (London, England) Sep 2019
Topics: Humans; Medical Errors; Patient Safety; Quality of Health Care; World Health Organization
PubMed: 31526719
DOI: 10.1016/S0140-6736(19)32080-X -
Annals of Internal Medicine Mar 2013Medication reconciliation identifies and resolves unintentional discrepancies between patients' medication lists across transitions in care. The purpose of this review... (Review)
Review
Medication reconciliation identifies and resolves unintentional discrepancies between patients' medication lists across transitions in care. The purpose of this review is to summarize evidence about the effectiveness of hospital-based medication reconciliation interventions. Searches encompassed MEDLINE through November 2012 and EMBASE and the Cochrane Central Register of Controlled Trials through July 2012. Eligible studies evaluated the effects of hospital-based medication reconciliation on unintentional discrepancies with nontrivial risks for harm to patients or 30-day postdischarge emergency department visits and readmission. Two reviewers evaluated study eligibility, abstracted data, and assessed study quality. Eighteen studies evaluating 20 interventions met the selection criteria. Pharmacists performed medication reconciliation in 17 of the 20 interventions. Most unintentional discrepancies identified had no clinical significance. Medication reconciliation alone probably does not reduce postdischarge hospital utilization but may do so when bundled with interventions aimed at improving care transitions.
Topics: Emergency Service, Hospital; Humans; Medical History Taking; Medication Reconciliation; Patient Discharge; Patient Readmission; Patient Safety; Pharmacists; Professional Role; Risk Assessment
PubMed: 23460096
DOI: 10.7326/0003-4819-158-5-201303051-00006