Building a NICU quality & safety infrastructure.

The American Academy of Pediatrics (AAP) Standards for Levels of Neonatal Care, published in 2023, highlights key components of a Neonatal Patient Safety and Quality Improvement Program (NPSQIP). A comprehensive Neonatal Intensive Care Unit (NICU) quality and safety infrastructure (QSI) is based on four foundational domains: quality improvement, quality assurance, safety culture, and clinical guidelines. This paper serves as an operational guide for NICU clinical leaders and quality champions to navigate these domains and develop their local QSI to include the AAP NPSQIP standards.

Associations between patient safety culture and workplace safety culture in hospital settings.

BACKGROUND: Strong cultures of workplace safety and patient safety are both critical for advancing safety in healthcare and eliminating harm to both the healthcare workforce and patients. However, there is currently minimal published empirical evidence about the relationship between the perceptions of providers and staff on workplace safety culture and patient safety culture. METHODS: This study examined cross-sectional relationships between the core Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey 2.0 patient safety culture measures and supplemental workplace safety culture measures. We used data from a pilot test in 2021 of the Workplace Safety Supplemental Item Set, which consisted of 6,684 respondents from 28 hospitals in 16 states. We performed multiple regressions to examine the relationships between the 11 patient safety culture measures and the 10 workplace safety culture measures. RESULTS: Sixty-nine (69) of 110 associations were statistically significant (mean standardized ß = 0.5; 0.58 < standardized ß < 0.95). The largest number of associations for the workplace safety culture measures with the patient safety culture measures were: (1) overall support from hospital leaders to ensure workplace safety; (2) being able to report workplace safety problems without negative consequences; and, (3) overall rating on workplace safety. The two associations with the strongest magnitude were between the overall rating on workplace safety and hospital management support for patient safety (standardized ß = 0.95) and hospital management support for workplace safety and hospital management support for patient safety (standardized ß = 0.93). CONCLUSIONS: Study results provide evidence that workplace safety culture and patient safety culture are fundamentally linked and both are vital to a strong and healthy culture of safety.

24Model-based comparative analysis of two catastrophic hazardous chemical pipeline accidents.

Objectives. This study conducted a comparative analysis of two catastrophic pipeline accidents in China in order to identify some common mistakes and lessons learned to prevent similar accidents. Methods. The 24Model was used in this study, which provides a universal pathway for accident analysis from the individual level to the organizational level. Results. There were similarities between the two cases in the aspects of the occurrence, development, emergency and causation at different levels: both were caused by leaks of pipelines and evolved into multiple explosions during emergency response; both leaks were caused by the corrosion of pipelines in the confined space of a damp or salt-spray environment; both were classified as 'responsibility accidents', and unsafe acts, such as the failure to identify hidden hazards of pipelines that were the direct cause of accidents, reflected the shortcomings of individual safety habitual behaviour in terms of knowledge, awareness, habits and psychology; weaknesses in the organizational management mainly concerned hazard identification, pipeline maintenance, emergency disposal, etc.; and there is not a good safety climate within the organization. Conclusions. Organizations should develop a closed-loop management system and strengthen the construction of safety culture, and the government should supervise the implementation of procedures.

El trabajo en equipo y la seguridad del paciente / Teamwork and patient safety

En este artículo se relaciona el trabajo en equipo con la seguridad del paciente y la importancia de su enseñanza en las carreras universitarias. Esto surge ante la creciente complejidad del sistema de salud que presenta mayores posibilidades de error. De esta manera aparece el trabajo en equipo como una herramienta fundamental para el ejercicio profesional. El avance tecnológico llevó a una transformación cultural y a la horizontalización de la estructura organizacional, aunque la figura del líder sigue resultando de importancia para no perder el tradicional enfoque humanístico. La enseñanza universitaria debe tratar este problema desde que el estudiante ingresa hasta que egresa para mejorar las tomas de decisiones y brindar seguridad

This article relates teamwork to patient safety and the importance of teaching it in university courses. This arises due to the growing complexity of the health system, which presents greater possibilities of error. In this way, teamwork appears as a fundamental tool for professional practice. Technological advancement led to a cultural transformation and the horizontalization of the organizational structure, although the figure of the leader continues to be important so as not to lose the traditional humanistic approach. University education must address this problem from the moment the student enters until he or she graduates to improve decision-making and provide security

Rethinking frontline health workers' safety performance in times of pandemic: the role of spiritual leadership.

This study examined the impact of spiritual leadership style on frontline health workers' safety performance through the mediating role of safety climate. Also, leader-member exchange (LMX) was examined as a moderator of the safety climate and safety performance relationship. Survey data from 582 frontline health workers in Ghana's Greater Accra and Ashanti regions were analyzed using AMOS version 23. Findings showed that spiritual leadership dimensions significantly influenced health workers' safety performance. Altruistic love and vision also significantly influenced safety climate. However, hope did not influenced safety climate. Moreover, safety climate had an impact onsafety performance dimensions. Furthermore, safety climate mediated the relationship between altruistic love, vision, and safety performance. However, safety climate did not mediate the relationship between hope and safety performance. Lastly, LMX moderated the positive effect of safety climate on safety compliance but not on safety participation. This study offers valuable insights for improving frontline health workers' safety performance during pandemics.

Understanding the 'blues of safety professionals'.

Something is not right in the safety profession. Many books written by professionals in the 2010s express a strong discontent. These professionals are highly critical of their situation, practice, role and identity. In these books, they express what this article describes as the 'blues of safety professionals'. Although varying in writing style, tone, theoretical inspiration, emphasis and experience, they address similar issues which relate to practices corresponding, in their eyes, to outmoded, inadequate or even perverse ideas. The aim of this article is to introduce, summarize, explain and problematize the significance of this literature. Following a methodological section, the 'safety professional blues' is introduced. It is argued in another section that the 'blues' pinpoints what these authors consider to be flawed assumptions about many of the core ingredients of the safety profession. The roots of this discontent are the topic of another section, while a final section problematizes the 'blues'.

A systematic comparison of hepatobiliary adverse drug reactions in FDA and EMA drug labeling reveals discrepancies.

Drug labeling informs physicians and patients on the safe and effective use of medication. However, recent studies suggested discrepancies in labeling of the same drug between different regulatory agencies. Here, we evaluated the hepatic safety information in labeling for 549 medications approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Limited discrepancies were found regarding risk for hepatic adverse drug reactions (ADRs) (8.7% in hepatic ADR warnings and 21.3% in contraindication for liver disease), while caution should be exercised over drugs with inconsistencies in contraindications for liver disease and evidence for hepatotoxicity (4.9%). Most discrepancies were attributable to less-severe hepatic events and low-frequency hepatic ADR reports and had limited implication on clinical outcomes.

Organizational Safety Climate and Job Enjoyment in Hospital Surgical Teams With and Without Crew Resource Management Training.

OBJECTIVE: The association between organizational safety climate (OSC) and job enjoyment (JE) for team members in surgical units in 2 hospitals was investigated. The treatment hospital received airline industry-based crew resource management (CRM) training, and the comparison hospital did not. BACKGROUND: Strong OSC has been positively associated with healthy hospital work environments and was expected to also be associated with employee job enjoyment. METHODS: Two hundred sixty-two surgical personnel responded to surveys about OSC and JE. RESULTS: The effects of OSC on JE did not depend on having CRM training. However, OSC and JE scores were higher in the treatment hospital, and the main effect of OSC and JE scores in the treatment hospital was highly significant (P < 0.001), with higher safety climate scores associated with higher JE. CONCLUSIONS: A strong OSC is important to employee job enjoyment. Nurse leaders should promote measures to strengthen the OSC in their surgical services departments.

Health and safety risk perceptions and needs of app-based drivers during COVID-19.

BACKGROUND: App-based drivers face work disruptions and infection risk during a pandemic due to the nature of their work, interactions with the public, and lack of workplace protections. Limited occupational health research has focused on their experiences. METHODS: We surveyed 100 app-based drivers in Seattle, WA to assess risk perceptions, supports, and controls received from the company that employs them, sources of trust, stress, job satisfaction, COVID-19 infection status, and how the pandemic had changed their work hours. Data were summarized descriptively and with simple regression models. We complemented this with qualitative interviews to better understand controls and policies enacted during COVID-19, and barriers and facilitators to their implementation. RESULTS: Drivers expressed very high levels of concern for exposure and infection (86%-97% were "very concerned" for all scenarios). Only 31% of drivers reported receiving an appropriate mask from the company for which they drive. Stress (assessed via PSS-4) was significantly higher in drivers who reported having had COVID-19, and also significantly higher in respondents with lower reported job satisfaction. Informants frequently identified supports such as unemployment benefits and peer outreach among the driver community as ways to ensure that drivers could access available benefits during COVID-19. CONCLUSIONS: App-based drivers received few protections from the company that employed them, and had high fear of exposure and infection at work. There is increased need for health-supportive policies and protections for app-based drivers. The most effective occupational and public health regulations would cover employees who may not have a traditional employer-employee relationship.

Consideration about the society after the COVID-19.

This paper reviews three viewpoints regarding the society after the COVID-19 infection on the concept of safety management. The first is the relationship between With COVID-19 and a zero risk. As a result of coexistence with COVID-19 for more than one year, the Japanese society thought that a zero risk is difficult to accomplish, and some risks will be accepted to maintain social activities. This leads a change in a way of thinking from zero risk to risk-based safety management. The second is the change in the way of working. As a result of having experienced remote work forcibly, it will become the hybrid model that incorporated remote work in a conventional method. Personnel evaluation changes from the seniority system to the job evaluation type, and each person's professional ability will be more focused on. The third is the review of the Japanese society system. In Japan, although the infection level was controlled to some extent by the groupism of the self-restraint of actions by mutual monitoring, there is a limit of managing based on groupism. Moreover, as seen in the delay of vaccine development and the medical care collapse, these problems should be improved by changing Japanese society system.

Examining the Effectiveness of Strategies Developed to Create an Error Reporting Culture.

PURPOSE: This study was conducted to develop strategies for creating an error reporting culture and to assess their effectiveness. DESIGN: This study was planned to explore how to improve patient safety. The study used a quasi-experimental 1-group pre-post design. It examined the culture of reporting through an analysis of employees' attitudes toward medical errors, along with rates of medical error reporting. METHODS: Four different forms were used as data collection tools. The multiple strategies used in this study constituted the research interventions. These strategies were as follows: "Education on Medical Errors and Medical Error Reporting," "Posting Banners and Posters about the Subject," "Using Social Networks and Creating a Facebook Page Titled 'Leaders of Patient Safety'," "Revising the Institution's Incident/Error Reporting System," and "Patient Safety Symposium." Data were evaluated using descriptive statistics and paired sample t test. RESULTS: It was determined that medical error reporting rates increased in the first 6 months after the initiative, and this increase continued in the second 6 months. Medical error reports in the institution where this study was conducted increased by 10 times at the end of the first year. CONCLUSIONS: Multiple strategies applied for creating an error reporting culture and assessing their effectiveness positively affected health professionals' medical error attitudes and increased error reporting rates.

Reimagining Construction and Renovation of Health Care Facilities During Emergence from a Pandemic.

The built environment has been integral to response to the global pandemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In particular, engineering controls to mitigate risk of exposure to SARS-CoV-2 and other newly emergent respiratory pathogens in the future will be important. Anticipating emergence from this pandemic, or at least adaptation given increasing administration of effective vaccines, and the safety of patients, personnel, and others in health care facilities remain the core goals. This article summarizes known risks and highlights prevention strategies for daily care as well as response to emergent infectious diseases and this parapandemic phase.

Using Participatory Design to Mitigate Hospital Patient Falls.

Participatory design can involve, empower, and facilitate those stake-holders (health care providers, nurses, professional development experts, patients, and patients' families) who can positively impact patient falls through the design process. Participatory design can help participants identify effective solutions to prevent patient falls and solve other health care problems. This article guides professional development specialists on how to use participatory design to solve health care problems with a focus on fall reduction. [J Contin Educ Nurs. 2021;52(8):359-361.].

Patient safety management systems and activities related to promoting voluntary in-hospital reporting and mandatory national-level reporting for patient safety issues: A cross-sectional study.

Both voluntary in-hospital reporting and mandatory national-level reporting systems for patient safety issues need to work well to develop a patient safety learning system that is effective in preventing the recurrence of adverse events. Some of the hospital systems and activities may increase voluntary in-hospital reporting and mandatory national-level reporting. This study aimed to identify the hospital systems and activities that increase voluntary in-hospital reporting and mandatory national-level reporting for patient safety issues. An anonymous mail survey of hospitals in Japan was conducted in 2017. The hospitals were selected by stratified random sampling according to number of beds. The survey examined the annual number of reported events in the voluntary in-hospital reporting system for patient safety and experience of reporting unexpected patient deaths possibly due to medical interventions to the mandatory national-level reporting system in the last 2 years. The relationship of the answer to the questions with the patient safety management systems and activities at each hospital was analyzed. The response rate was 18.8% (603/3,215). The number of in-hospital reports per bed was positively related to identifying events by referring complaints or questions of patients or family members, using root cause analysis for analyzing reported events, and developing manuals or case studies based on reported events, and negatively related to the unification and standardization of medical devices and equipment. The experience with mandatory national-level reporting of serious adverse events was positively related to identifying problematic cases by a person in charge of patient safety management from the in-hospital reporting system of complications and accidental symptoms. Enhanced feedback for reporters may promote voluntary in-hospital reporting of minor cases with low litigation risks. Developing an in-hospital mechanism that examines all serious complications and accidental symptoms may promote mandatory national-level reporting of serious adverse events with high litigation risks.

The management of the new and emerging musculoskeletal and psychosocial risks by EU-28 enterprises.

INTRODUCTION: Although the strategic framework of the European Union in the field of Health and Safety at Work 2014-2020 considers as one of its main challenges to improve the prevention of diseases related to NERs (New and Emerging Risks) (European Commission, 2014) there are still not many studies in the literature related to them. METHOD: An exploratory study was carried out in order to get a picture of the NERs management in the UE-28 countries. The sample was extracted from the ESENER-2 datasets. ESENER-1 was carried out in 2009 and ESENER- 2 in 2014. This survey explores managers' and workers representatives' opinions on health and safety management. It surveyed over 49,000 enterprises in 36 countries. RESULTS: The results obtained confirm that there are significant differences between the EU-28 countries in terms of the identification and the management of NERs. Conclusions NERs are becoming an increasingly studied phenomenon due to the changes that are taking place in the labour market: the percentage of temporary workers is increasing, the demands to the workers due to the globalization of the market are more complex and all this with an aging working force. Pratical A pplications It would be necessary to rethink the management of OHS, so that managers are aware that the combination of musculoskeletal and psychosocial risks should have a global approach in order to reduce accident and disability rates.

Advocacy for School Nurses and Student Health and Safety: Highlighting National and State Efforts.

Annually, the National Association of School Nurses (NASN) sets advocacy goals. The goals include legislative and policy priorities. The COVID-19 pandemic brought attention to the need to heighten advocacy efforts, specifically to provide for additional school nurses and supplies necessary to meet the challenge of safely returning students to school. While advocating at the national level, NASN also encouraged advocacy at the state and local levels. This article provides a brief summary of NASN's advocacy efforts as well as providing examples from two different state associations demonstrating the importance of collaboration in advocacy efforts in areas related to the pandemic and in general areas related to school nursing.

Perioperative patient safety management activities: A modified theory of planned behavior.

Patient safety is an important healthcare issue worldwide, and patient accidents in the operating room can lead to serious problems. Accordingly, we investigated the explanatory ability of a modified theory of planned behavior to improve patient safety activities in the operating room. Questionnaires were distributed to perioperative nurses working in 12 large hospitals in Korea. The modified theory of planned behavior data from a total of 330 nurses were analyzed. The conceptual model was based on the theory of planned behavior data, with two additional organizational factors-job factors and safety management system. Individual factors included attitude, subjective norms, perceived behavioral control, behavioral intention, and patient safety management activities. Results indicated that job factors were negatively associated with perceived behavioral control. The patient safety management system was positively associated with attitude, subjective norm, and perceived behavioral control. Attitude, subjective norm, and perceived behavioral control were positively associated with behavioral intention. Behavioral intention was positively associated with patient safety management activities. The modified theory of planned behavior effectively explained patient safety management activities in the operating room. Both organizations and individuals are required to improve patient safety management activities.