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Journal of Patient Safety Mar 2020This study aimed to help alleviate the shortage of reliable information on clinical care issues; the Spanish Observatory of Dental Patient Safety (OESPO) has resorted to...
OBJECTIVES
This study aimed to help alleviate the shortage of reliable information on clinical care issues; the Spanish Observatory of Dental Patient Safety (OESPO) has resorted to the study of legal claims by patients and searched those which produced clinical problems.
METHODS
Based on OESPO data, this article proposes 11 basic procedures/practices for dental patient safety to help mitigate most preventable adverse events.
RESULTS
The sample of the OESPO is large (415 adverse events studied), but it has the bias of a judicial source. However, the results provide an interesting approach to clinical safety in dentistry. When studying in detail the causes that led to preventable adverse events, it can be seen that most of these (and most severe) events have been caused by a small number of erroneous behaviors.
CONCLUSIONS
Most preventable adverse events during the dental health care are produced by a relatively small number of causes. Therefore, a few basic safety procedures can reduce significantly these preventable adverse events.
Topics: Dental Care; Female; Humans; Male; Patient Safety
PubMed: 26273929
DOI: 10.1097/PTS.0000000000000234 -
Journal of Patient Safety Jun 2019In 2012, a 6-month Patient Safety Rounds pilot program was conducted to examine the provider perspective of patient safety and to educate personnel about national...
OBJECTIVE
In 2012, a 6-month Patient Safety Rounds pilot program was conducted to examine the provider perspective of patient safety and to educate personnel about national patient safety goals at clinics associated with a large research and education institution.
METHODS
The Patient Safety Rounds (PSR) team, consisting of 3 to 4 rotating members from executive leadership, physician and nursing groups, and administrative staff, identified contacts within clinical departments and made arrangements for monthly visits. Patient safety issues were preselected by committee for presentation and discussion at a premeeting held with supervisors and administrators during the first few minutes of PSR. After the premeeting, the PSR team split up and met individually with care providers, between patient visits, to review the monthly safety topic and any patient safety concerns that they wanted to discuss during the visit.
RESULTS
Approximately 37 patient safety issues were identified, recorded, and classified during these PSR team visits. If the issues could not be immediately addressed, they were either addressed shortly thereafter or referred to appropriate personnel for resolution.
CONCLUSIONS
This PSR pilot program was viewed as a success by participants because it identified provider perspective concerns, which led to the identification and resolution of numerous patient safety issues. This interesting pilot program, however, was discontinued owing to the departure of key leadership and the reorganization and reprioritization of resources.
Topics: Academies and Institutes; Humans; Patient Safety; Pilot Projects
PubMed: 26102001
DOI: 10.1097/PTS.0000000000000216 -
Journal of Healthcare Management /... 2019Financial issues are top concerns for hospital executives. Evolving reimbursement structures focused on value provide an incentive to fully understand how patient safety...
Financial issues are top concerns for hospital executives. Evolving reimbursement structures focused on value provide an incentive to fully understand how patient safety performance and financial outcomes are connected. To that end, this study examines the relationships between Surgical Care Improvement Project (SCIP) measurements and hospital financial performance.Using multinomial logistic regression, we determined the association between hospital patient safety performances via analysis of eight prophylaxis data elements drawn from the archived Hospital Compare data. The measures are SCIP-Inf-1 (prophylactic antibiotic prophylaxis received within 1 hr prior to surgical incision), SCIP-Inf-2 (prophylactic antibiotic selection for surgical patients), SCIP-Inf-3 (prophylactic antibiotics discontinued within 24 hr after surgery end time), SCIP-Inf-4 (cardiac surgery patients with controlled 6 A.M. postoperative serum glucose management), SCIP-Inf-9 (urinary catheter removal postsurgery), SCIP-Inf-Card-2 (beta-blocker during the perioperative period), and SCIP-Inf-VTE-2 (venous thromboembolism prophylaxis). Data from the American Hospital Association provided two dimensions of organizational profitability: operating margin and net patient revenue. Our results indicate that improved hospital safety performance is associated with a relative risk of higher operating margin and net patient revenue, with some variation noted among the measures of patient safety. Our findings suggest that targeted improvement in patient safety performance, as evaluated in the Hospital Compare data, is associated with improved financial performance at the hospital level. Increased attention to safe care delivery may allow hospitals to generate additional patent care earnings, improve margins, and create capital to advance hospital financial position.
Topics: Economics, Hospital; General Surgery; Patient Safety; Quality Improvement
PubMed: 31999263
DOI: 10.1097/JHM-D-17-00208 -
International Emergency Nursing Sep 2019Patients who call for an ambulance but only have primary care needs do not always get appropriate care. The starting point in this study is that such patients should be... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Patients who call for an ambulance but only have primary care needs do not always get appropriate care. The starting point in this study is that such patients should be assigned to as basic of care as possible, while maintaining high levels of patient trust and patient safety.
AIM
To evaluate patient trust and patient safety among low-priority ambulance patients referred to care at either the Community Health Centre (CHC) or the Emergency Department (ED).
METHODS
This randomized controlled trial pilot study compared the level of patient trust and patient safety among low-priority ambulance patients who were randomized into two groups: CHC (n = 105) or ED (n = 83).
RESULTS
There was a high level of trust in the care received, regardless of whether the patient received care at CHC or ED. Overall 31% fulfilled one or more of the given criteria for potentially jeopardizing patient safety.
CONCLUSION
Patient selection for the trial indicated a potential limit in patient safety. There was a high level of trust in the care received regardless of whether the patient received care. The accuracy of patient selection for the new care model needs to be further improved with the intention to enhance patient safety even further.
Topics: Adult; Aged; Aged, 80 and over; Emergency Medical Services; Female; Humans; Male; Middle Aged; Patient Acuity; Patient Safety; Pilot Projects; Psychometrics; Surveys and Questionnaires; Sweden; Trust
PubMed: 31331836
DOI: 10.1016/j.ienj.2019.06.001 -
Rehabilitation Nursing : the Official... 2018Falls are a major safety issue in rehabilitation settings. Patients receive mixed messages-try to be as independent as possible, but don't do anything in your room...
PURPOSE
Falls are a major safety issue in rehabilitation settings. Patients receive mixed messages-try to be as independent as possible, but don't do anything in your room without calling for assistance. Despite the use of multiple falls interventions at this facility, the fall rate remained high. To impact this rate, the facility implemented a video monitoring system. This system allows for patients at risk for falling to be monitored from a remote location. The monitor technician is able to speak to the patient directly and/or contact staff members to respond to the room, preventing a fall.
DESIGN
Sequential cohort design.
METHOD
Fifteen video monitoring units were installed on high-risk units in a 115-bed inpatient rehabilitation facility. Total falls and falls rates were tracked and reported pre- and postimplementation.
FINDINGS
Over a 21-month period prior to implementing the video monitoring system, the average hospital-wide rate of falls was 6.34 per 1,000 patient-days (SD = 1.7488). After a year of usage, that average has decreased to 5.099 falls per 1,000 patient-days (SD = 1.524). The reduction in falls was statistically significant. In addition, there have been significant cost savings by reducing sitter usage.
CONCLUSIONS
Video monitoring can improve patient safety by decreasing falls; decreasing sitter usage and cost; and improving patient, family, and staff satisfaction.
CLINICAL RELEVANCE
Falls are a significant issue in rehabilitation settings, and current fall prevention strategies fall short of reducing fall rates. Implementation of new video monitoring technology can help reduce fall rates in inpatient rehabilitation settings.
Topics: Accidental Falls; Cohort Studies; Computer Terminals; Humans; Monitoring, Physiologic; New York; Patient Safety; Rehabilitation Nursing
PubMed: 29499009
DOI: 10.1097/RNJ.0000000000000089 -
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 -
Journal of Pediatric Urology Oct 2019
Topics: Child; Humans; Patient Safety; Quality Improvement; Surgical Procedures, Operative
PubMed: 31477415
DOI: 10.1016/j.jpurol.2019.07.019 -
Journal of Pediatric Urology May 2019
Topics: Decision Making, Shared; Humans; Orthopedic Procedures; Patient Safety; Quality Improvement
PubMed: 31221399
DOI: 10.1016/j.jpurol.2019.05.036 -
Nurse Education in Practice Jul 2019Patient safety is crucial to healthcare quality. It is important to assess the nursing students' safety attitudes to identify the weaknesses for developing education...
Patient safety is crucial to healthcare quality. It is important to assess the nursing students' safety attitudes to identify the weaknesses for developing education program and fostering students' engagement in patient safety practices. This study aimed to assess attitudes towards patient safety culture among postgraduate nursing students in China, and explore the factors that affect their safety attitudes and the relationships of safety attitudes and safety-related behaviors. This study used a cross-sectional survey design. A convenience sample of 231 postgraduate nursing students from ten medical universities in China completed the Chinese version of Safety Attitude Questionnaire, including six domains: teamwork climate, safety climate, perceptions of management, job satisfaction, working conditions and stress recognition. The mean scores of the six domains ranged from 65.22 to 70.75 on a 100-point scale. Percentages of positive responses for the six domains were below 55%, with the two lowest percentages for working conditions (35.9%) and safety climate (30.7%). Significantly lower domain scores were found in students with younger age, no work experience, higher workload and received safety education. There were positive correlations between the six domains and safety-related behaviors except for stress recognition. Nursing educators should focus more on the improvement of patient safety education and establishment of supportive work environment to enhance postgraduate nursing students' attitudes towards safety culture.
Topics: Adult; Attitude of Health Personnel; China; Cross-Sectional Studies; Education, Nursing, Graduate; Female; Humans; Male; Organizational Culture; Patient Safety; Safety Management; Students, Nursing; Surveys and Questionnaires
PubMed: 31163311
DOI: 10.1016/j.nepr.2019.05.014 -
Journal of Patient Safety Mar 2016In this article, we explore how researchers can contribute to patient safety improvement. We aim to expand the instrumental role researchers have often occupied in...
OBJECTIVES
In this article, we explore how researchers can contribute to patient safety improvement. We aim to expand the instrumental role researchers have often occupied in relation to patient safety improvement.
METHODS
We reflect on our own improvement model and experiences as patient safety researchers in an ongoing Finnish multi-actor innovation project through self-reflective narration.
RESULTS
Our own patient safety improvement model can be described as systemic. Based on the purpose of the innovation project, our improvement model, and the improvement models of the other actors in the project, we have carried out a wide range of activities. Our activities can be summarized in 8 overlapping patient safety improvement roles: modeler, influencer, supplier, producer, ideator, reflector, facilitator, and negotiator.
CONCLUSIONS
When working side by side with "practice," researchers are offered and engage in several different activities. The way researchers contribute to patient safety improvement and balance between different roles depends on the purpose of the study, as well as on the underlying patient safety improvement models. Different patient safety research paradigms seem to emphasize different improvement roles, and thus, they also face different challenges. Open reflection on the underlying improvement models and roles can help researchers with different backgrounds-as well as other actors involved in patient safety improvement-in structuring their work and collaborating productively.
Topics: Cooperative Behavior; Finland; Humans; Patient Safety; Professional Role; Quality Improvement; Research Design; Research Personnel
PubMed: 24618644
DOI: 10.1097/PTS.0000000000000096