Prevalence of pressure injury on the medical wards of public general hospitals in Kuwait: a national cross-sectional study.

BACKGROUND: Pressure injury is a severe problem that can significantly impact a patient's health, quality of life, and healthcare expenses. The prevalence of pressure injuries is a widely used clinical indicator of patient safety and quality of care. This study aims to address the research gap that exists on this topic in Kuwait by investigating the prevalence of pressure injuries and preventive measures on the medical wards of the country's public general hospitals. METHODS: A cross-sectional research design was adopted to measure the point prevalence of pressure injuries on 54 medical wards in the public general hospitals. Data, including variables pertaining to hospitals, patients, pressure injuries and preventive practices, were collected using an online form. The data were processed and analysed using Microsoft Excel and SPSS 23 (α level = 0.05). Analysis provided an overview of patient, pressure injury characteristics and preventive measures, and the relationships between the patient and pressure injury characteristics and the prevalence of pressure injuries. A model for predicting the determinants of pressure injury prevalence was constructed from a linear regression analysis. RESULTS: The mean national prevalence of pressure injury was 17.6% (95% CI: 11.3-23.8). Purely community-acquired pressure injuries represent the majority of pressure injuries nationally (58.1%). Regarding preventive measures, "pressure injury assessment on admission" has been provided to 65.5% of patients. Correlation analysis revealed that the only statistically significant correlation with the prevalence of hospital-acquired pressure injury was "pressure injury assessment on admission", which was strongly negative (ρ = -0.857). Therefore, this was the only variable included in the regression analysis as a predictor of pressure injury prevalence (Beta = 0.839). The results showed many statistically significant differences between hospitals with respect to the variables studied. CONCLUSIONS: The national pressure injury prevalence is high compared to the global rate. The higher percentage of purely community-acquired pressure injuries requires particular attention. Many risk factors for the development of pressure injuries are public health concerns, and effective mitigating strategies are needed. Further research is required to assess the knowledge, attitude, and behaviour of nurses with respect to pressure injuries, and to evaluate preventive and management practices.

The Association Between Patient Safety Culture and Accreditation at Primary Care Centers in Kuwait: A Country-Wide Multi-Method Study.

Purpose: A culture of patient safety is essential for the continual improvement of service and reducing errors. This study aims to examine how the scores of patient safety culture items impact accreditation compliance percentages in primary care settings in Kuwait. Methods: A cross-sectional and a retrospective quantitative approaches were used on 5288 employees at 75 primary healthcare centers across Kuwait. Patient safety culture questionnaires were distributed to clinical and administrative staff with at least one year of experience. We also examined the percentages of compliance with accreditation standards by the studied centers. Participant socio-demographic and setting demographic data were studied using univariate (means, standard deviations, frequencies, percentages) and bivariate (Student's t-tests, ANOVA F-tests, Mann-Whitney U-test, Kruskal-Wallis H-test, Spearman correlation) analyses to examine how trends in the patient safety culture items and accreditation compliance differ across the primary healthcare center demographic groups. The relationship between patient safety culture composites and percentages of accreditation compliance was investigated. To predict the factors for accreditation compliance, we used multivariate regression analysis. Results: The responses of 5288 employees (response rate= 76.5%) from 75 centers were included. Our analysis revealed that the demographics of the setting affected the accreditation compliance percentage more than the percentages of patient safety culture positive ratings. Furthermore, the composites "Patient Care Tracking/Follow-up", "Communication about Error", "Organizational Learning" and "Overall Perceptions of Patient Safety & Quality" had statistically significant weak-to-moderate positive correlations (r = 0.272-0.373) with percentage scores for compliance with various accreditation standards. Regression analysis indicated that the patient safety culture items accounted for 35% to 38% of the variability in accreditation compliance scores. Conclusion: The safety practices adopted by a primary healthcare center reflect its culture, and this has an impact on its accreditation performance. Our interpretation of the findings is expected to help healthcare leaders to better understand the relationship between safety culture and performance and to develop realistic reform strategies.

Baseline assessment of staff perception of critical value practices in government hospitals in Kuwait.

BACKGROUND: Notification of laboratory-determined critical values is key for effective clinical decision making and is thus a consequential step in a patient's health care and safety. This study presents an overview of staff reporting policies and procedures concerning critical values in Kuwaiti governmental hospitals. METHODS: A cross-sectional descriptive study design was adopted. Study subjects were affiliated with laboratories from five government hospitals (four general and one sub-specialty hospital). All laboratory staff in every hospital were included. The Statistical Package for the Social Sciences (version 23) was used to analyse the collected data at a significance level of ≤ 0.05. Quantitative data analysis included univariate descriptive (means, medians, standard deviations, frequencies, percentages) and bivariate (chi-squared, ANOVA and Kruskal-Wallis tests) analyses. These analyses provided associations between participating hospitals and staff perceptions towards the policies and procedures surrounding critical values. RESULTS: 559 questionnaires were returned, a total response of 30.5% after those of 79 phlebotomists were excluded (eligible sample size n = 1833). The notification of critical values differs between participated laboratories in delivering protocol and time duration. Linked protocols between laboratories did not exist regarding policies and guidelines for applying the same procedures for critical value notification. There are differences in critical value limits among the participating laboratories. CONCLUSION: This study is the first to survey laboratory staff perceptions of critical value practices in Kuwaiti government hospitals. Enhancing critical value reporting and policy is crucial for improving patient safety and to develop high-quality health services. The findings of this study can help policy makers implement future intervention studies to enhance laboratory practices in the area of critical values and improve patient safety and the quality of government hospital systems.

Baseline assessment of patient safety culture in primary care centres in Kuwait: a national cross-sectional study.

BACKGROUND: Assessments of the culture surrounding patient safety can inform healthcare settings on how their structures and processes impact patient outcomes. This study investigated patient safety culture in Primary Health Care Centres in Kuwait, and benchmarked the findings against regional and international results. This study also examined the association between predictors and outcomes of patient safety culture in these settings. METHODS: This cross-sectional quantitative study used the Medical Office Survey on Patient Safety Culture. The study was targeted at staff of all the Primary Health Care Centres in Kuwait with at least one year of experience. Data were analysed using SPSS 23 at a significance level of ≤ .05. Univariate (means, standard deviations, frequencies, percentages) and bivariate (chi-squared tests, student t-tests, ANOVA F-tests, Kruskal-Wallis tests, Spearman's correlation) analyses provided an overview of participant socio-demographics and the association between patient safety culture composites and outcomes. We undertook a multivariate regression analysis to predict the determinants of patient safety culture. Results were benchmarked against similar local (Kuwait, 2014), regional (Yemen, 2015) and international (US, 2018) studies. RESULTS: The responses of 6602 employees from 94 centres were included in the study, with an overall response rate of 78.7%. The survey revealed Teamwork (87.8% positive ratings) and Organisational Learning (78.8%) as perceived areas of strength. Communication about Error (57.7%), Overall Perceptions of Patient Safety and Quality (57.4%), Communication Openness (54.4%), Owner/Managing Partner/Leadership Support for Patient Safety (53.8%) and Work Pressure and Pace (28.4%) were identified as areas requiring improvement. Benchmarking analysis revealed that Kuwait centres are performing at benchmark levels or better on four and six composites when compared to international and regional findings, respectively. Regression modelling highlighted significant predictions regarding patient safety outcomes and composites. CONCLUSIONS: This is the first major study addressing the culture of patient safety in public Primary Health Care Centres regionally. Improving patient safety culture is critical for these centres to improve the quality and safety of the healthcare services they provide. The findings of this study can guide country-level strategies to develop the systems that govern patient safety practices.

Hospital Survey on Patient Safety Culture: psychometric evaluation in Kuwaiti public healthcare settings.

OBJECTIVE: As healthcare organisations endeavour to improve the quality and safety of their services, there is increasing recognition of the importance of building a culture of safety to promote patient safety and improve the outcomes of patient care. Surveys of safety culture/climate have not knowingly been conducted in Kuwait public hospitals, nor are valid or reliable survey instruments available for this context. This study aims to investigate the psychometric properties of the HSOPSC (Hospital Survey on Patient Safety Culture) tool in Kuwaiti public hospitals in addition to constructing an optimal model to assess the level of safety climate in this setting. DESIGN: Cross-sectional study. SETTING: Three public hospitals in Kuwait. PARTICIPANTS: About 1317 healthcare professionals. MAIN OUTCOME MEASURE: An adapted and contextualised version of HSOPSC was used to conduct psychometric evaluation including exploratory factor analysis, confirmatory factor analysis reliability and correlation analysis. RESULTS: 1317 questionnaires (87%) were returned. Psychometric evaluation, showed an optimal model of eight factors and 22 safety climate items. All items have strong factor loadings (0.42-0.86) and are theoretically related. Reliability analysis showed satisfactory results (α >0.60). CONCLUSIONS: This is the first validation study of a standardised safety climate measure in a Kuwaiti healthcare setting. An optimal model for assessing patient safety climate was produced that mirrors other international studies and which can be used for measuring the prevailing safety climate. More importance should be attached to the psychometric fidelity of safety climate questionnaires before extending their use in other healthcare culture and contexts internationally.