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Journal of Patient Safety Apr 2021Despite decades of research, improving health care safety remains a global priority. Individual studies have demonstrated links between staff engagement and care... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Despite decades of research, improving health care safety remains a global priority. Individual studies have demonstrated links between staff engagement and care quality, but until now, any relationship between engagement and patient safety outcomes has been more speculative. This systematic review and meta-analysis therefore assessed this relationship and explored if the way these variables were defined and measured had any differential effect.
METHODS
After systematic searches of Medline, CINAHL, PsycInfo, Embase, Cochrane Library, and National Institute for Health Research Journals databases, narrative and random-effects meta-analyses were completed, with pooled effect sizes expressed as Pearson r.
RESULTS
Fourteen studies met the inclusion criteria, 11 of which were suitable for meta-analysis. Meta-analyses indicated a small but consistent, statistically significant relationship between staff engagement and patient safety (all outcomes; 11 studies; r = 0.22; 95% confidence interval [CI], 0.07 to 0.36; n = 30,490) and 2 patient safety outcome categories: patient safety culture (7 studies; r = 0.22; 95% CI, 0.01 to 0.41; n = 27,857) and errors/adverse events (4 studies; r = -0.20; 95% CI, -0.26 to -0.13; n = 2633). The specific approach to conceptualizing engagement did not affect the strength of the findings.
CONCLUSIONS
This is the first review to demonstrate a significant relationship between engagement and both safety culture scores and errors/adverse events. Despite a limited and evolving evidence base, we cautiously conclude that increasing staff engagement could be an effective means of enhancing patient safety. Further research is needed to determine causality and clarify the nature of the staff engagement/patient safety relationship at individual and unit/workgroup levels.
Topics: Delivery of Health Care; Humans; Patient Safety; Work Engagement
PubMed: 33427792
DOI: 10.1097/PTS.0000000000000807 -
Ergonomics 2015Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines... (Review)
Review
Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines how human factors and ergonomics (HFE) is applied to redesign healthcare work systems and processes and improve quality and safety of care. We identified 12 projects representing 23 studies and addressing different physical, cognitive and organisational HFE issues in a variety of healthcare systems and care settings. Some evidence exists for the effectiveness of HFE-based healthcare system redesign in improving process and outcome measures of quality and safety of care. We assessed risk of bias in 16 studies reporting the impact of HFE-based healthcare system redesign and found varying quality across studies. Future research should further assess the impact of HFE on quality and safety of care, and clearly define the mechanisms by which HFE-based system redesign can improve quality and safety of care.
Topics: Delivery of Health Care; Environment Design; Ergonomics; Humans; Patient Safety; Quality of Health Care
PubMed: 25323570
DOI: 10.1080/00140139.2014.959070 -
Revista Latino-americana de Enfermagem 2013The aim of this study was to analyze the potential association between nursing workload and patient safety in the medical and surgical inpatient units of a teaching...
OBJECTIVE
The aim of this study was to analyze the potential association between nursing workload and patient safety in the medical and surgical inpatient units of a teaching hospital.
METHOD
a mixed method strategy (sequential explanatory design).
RESULTS
the initial quantitative stage of the study suggest that increases in the number of patients assigned to each nursing team lead to increased rates of bed-related falls, central line-associated bloodstream infections, nursing staff turnover, and absenteeism. During the subsequent qualitative stage of the research, the nursing team stressed medication administration, bed baths, and patient transport as the aspects of care that have the greatest impact on workload and pose the greatest hazards to patient, provider, and environment safety.
CONCLUSIONS
The findings demonstrated significant associations between nursing workload and patient safety. We observed that nursing staff with fewer patients presented best results of care-related and management-related patient safety indicators. In addition, the tenets of ecological and restorative thinking contributed to the understanding of some of the aspects in this intricate relationship from the standpoint of nursing providers. They also promoted a participatory approach in this study.
Topics: Cross-Sectional Studies; Humans; Nursing; Patient Safety; Retrospective Studies; Workload
PubMed: 23459902
DOI: 10.1590/s0104-11692013000700019 -
Journal of General Internal Medicine Jul 2018Diagnostic error is a prevalent, harmful, and costly phenomenon. Multiple national health care and governmental organizations have recently identified the need to... (Review)
Review
Diagnostic error is a prevalent, harmful, and costly phenomenon. Multiple national health care and governmental organizations have recently identified the need to improve diagnostic safety as a high priority. A major barrier, however, is the lack of standardized, reliable methods for measuring diagnostic safety. Given the absence of reliable and valid measures for diagnostic errors, we need methods to help establish some type of baseline diagnostic performance across health systems, as well as to enable researchers and health systems to determine the impact of interventions for improving the diagnostic process. Multiple approaches have been suggested but none widely adopted. We propose a new framework for identifying "undesirable diagnostic events" (UDEs) that health systems, professional organizations, and researchers could further define and develop to enable standardized measurement and reporting related to diagnostic safety. We propose an outline for UDEs that identifies both conditions prone to diagnostic error and the contexts of care in which these errors are likely to occur. Refinement and adoption of this framework across health systems can facilitate standardized measurement and reporting of diagnostic safety.
Topics: Critical Care; Diagnostic Errors; Humans; Patient Safety
PubMed: 29380218
DOI: 10.1007/s11606-018-4304-2 -
Journal of Preventive Medicine and... Nov 2020The aim of the present study was to investigate the relationships among hospital safety climate, patient safety climate, and safety outcomes among nurses.
OBJECTIVES
The aim of the present study was to investigate the relationships among hospital safety climate, patient safety climate, and safety outcomes among nurses.
METHODS
In the current cross-sectional study, the occupational safety climate, patient safety climate, and safety performance of nurses were measured using several questionnaires. Structural equation modeling was applied to test the relationships among occupational safety climate, patient safety climate, and safety performance.
RESULTS
A total of 211 nurses participated in this study. Over half of them were female (57.0%). The age of the participants tended to be between 20 years and 30 years old (55.5%), and slightly more than half had less than 5 years of work experience (51.5%). The maximum and minimum scores of occupational safety climate dimensions were found for reporting of errors and cumulative fatigue, respectively. Among the dimensions of patient safety climate, non-punitive response to errors had the highest mean score, and manager expectations and actions promoting patient safety had the lowest mean score. The correlation coefficient for the relationship between occupational safety climate and patient safety climate was 0.63 (p<0.05). Occupational safety climate and patient safety climate also showed significant correlations with safety performance.
CONCLUSIONS
Close correlations were found among occupational safety climate, patient safety climate, and nurses' safety performance. Therefore, improving both the occupational and patient safety climate can improve nurses' safety performance, consequently decreasing occupational and patient-related adverse outcomes in healthcare units.
Topics: Adult; Attitude of Health Personnel; Cross-Sectional Studies; Female; Humans; Latent Class Analysis; Male; Middle Aged; Occupational Health; Patient Safety; Safety Management; Surveys and Questionnaires
PubMed: 33296585
DOI: 10.3961/jpmph.20.350 -
Family Practice Management Mar 2023
Topics: Humans; Patient Safety; Primary Health Care
PubMed: 36917724
DOI: No ID Found -
BMJ Open Quality May 2024The study aimed to study the association of leadership practices and patient safety culture in a dental hospital.
OBJECTIVES
The study aimed to study the association of leadership practices and patient safety culture in a dental hospital.
DESIGN
Hospital-based, cross-sectional study SETTING: Riphah Dental Hospital (RDH), Islamabad, Pakistan.
PARTICIPANTS
All dentists working at RDH were invited to participate.
MAIN OUTCOME MEASURES
A questionnaire comprised of the Transformational Leadership Scale (TLS) and the Dental adapted version of the Medical Office Survey of Patient Safety Culture (DMOSOPS) was distributed among the participants. The response rates for each dimension were calculated. The positive responses were added to calculate scores for each of the patient safety and leadership dimensions and the Total Leadership Score (TLS) and total patient safety score (TPSS). Correlational analysis is performed to assess any associations.
RESULTS
A total of 104 dentists participated in the study. A high positive response was observed on three of the leadership dimensions: inspirational communication (85.25%), intellectual stimulation (86%), and supportive leadership (75.17%). A low positive response was found on the following items: 'acknowledges improvement in my quality of work' (19%) and 'has a clear sense of where he/she wants our unit to be in 5 years' (35.64%). The reported positive responses in the patient safety dimensions were high on three of the patient safety dimensions: organisational learning (78.41%), teamwork (82.91%), and patient care tracking/follow-up (77.05%); and low on work pressure and pace (32.02%). A moderately positive correlation was found between TLS and TPSS (r=0.455, p<0.001).
CONCLUSIONS
Leadership was found to be associated with patient safety culture in a dental hospital. Leadership training programmes should be incorporated during dental training to prepare future leaders who can inspire a positive patient safety culture.
Topics: Humans; Leadership; Cross-Sectional Studies; Patient Safety; Surveys and Questionnaires; Male; Female; Pakistan; Adult; Dentistry; Middle Aged; Dentists; Attitude of Health Personnel; Safety Management
PubMed: 38719526
DOI: 10.1136/bmjoq-2023-002376 -
International Journal of Surgery... 2014The World Health Organization Surgical Safety Checklist (WHO SSC) has demonstrated efficacy in developed and developing countries alike. Recent increases in awareness of... (Review)
Review
The World Health Organization Surgical Safety Checklist (WHO SSC) has demonstrated efficacy in developed and developing countries alike. Recent increases in awareness of surgical morbidity in developing countries has placed greater emphasis on strategies to improve surgical safety in resource-limited settings. The implementation of surgical safety checklists in low-income countries has specific barriers related to resources and culture. Adapting and amending existing surgical safety checklists, as well as considering factors unique to developing countries, may allow the potential of this simple intervention to be fully harnessed in a wider setting. This review will address the benefits and challenges of implementation of surgical safety checklists in developing countries. Moreover, inspiration for the original checklist is revisited to identify areas that will be of particular benefit in a resource-poor setting. Potential future strategies to encourage the implementation of checklists in these countries are also discussed.
Topics: Checklist; Developing Countries; Humans; Patient Safety; Surgical Procedures, Operative
PubMed: 24239705
DOI: 10.1016/j.ijsu.2013.10.016 -
Revista Da Escola de Enfermagem Da U S P 2017OBJECTIVE To describe the workload of the nursing team and relate it with patient safety outcomes in clinical and surgical inpatient units of a university hospital....
OBJECTIVE To describe the workload of the nursing team and relate it with patient safety outcomes in clinical and surgical inpatient units of a university hospital. METHOD Cross-sectional study, carried out from October 2013 to September 2015. The factor under study was the workload, expressed as the ratio between the mean number of patients and the number of nursing professionals in 24 hours and in the day shifts. RESULTS The sample consisted of 157,481 patients, 502 nursing professionals and 264 observations of safety outcomes. The ratios of patients per nurse and per nursing technician in day shifts indicate a mean estimate of 14-15 and 5-6 patients per professional, respectively. There was a significant association between the workloads in the inpatient units and average length of stay, urinary infection related to invasive procedure and the satisfaction of patients with nursing care. CONCLUSION The increase in the workload of the nursing team had an impact on quality of care and safety for patients. An adequate staffing promotes a safer care environment.
Topics: Cross-Sectional Studies; Hospital Units; Hospitals, University; Humans; Nursing Staff, Hospital; Patient Safety; Quality Indicators, Health Care; Workload
PubMed: 29211232
DOI: 10.1590/s1980-220x2016021203255 -
International Dental Journal Aug 2012Although concern for patient safety is inherent to the practice of the health care professions, its transformation into a specific body of knowledge is relatively recent... (Review)
Review
Patient safety and dentistry: what do we need to know? Fundamentals of patient safety, the safety culture and implementation of patient safety measures in dental practice.
Although concern for patient safety is inherent to the practice of the health care professions, its transformation into a specific body of knowledge is relatively recent and thus patient safety may be considered as a comparatively 'new' discipline. Its main objectives are to avoid the occurrence of preventable adverse events (accidents, errors and complications) associated with health care and to limit the impact of inevitable adverse events. Despite these simple definitions, patient safety is multifaceted, quite complex in nature and includes many key elements. Thus, it cannot be simply defined as the provision of safe health care or the protection of patients from harm by health care providers because there are economic, fiscal, social, cultural and organisational aspects of a patient safety climate. It is essential for all health care practitioners and health care organisations to become more familiar with the general context of patient safety, to actively participate in efforts to implement patient safety measures in daily practice and to establish a patient safety culture.
Topics: Dental Care; Dentistry; Humans; Medical Errors; Patient Safety
PubMed: 23017000
DOI: 10.1111/j.1875-595X.2012.00119.x