[The origin and development of the application of ergonomics in patient safety].

Human factor and ergonomics (HFE) is a discipline focusing on the studies of the relation between the safety and human behavior and system design. The application of HFE in healthcare and patient safety can be traced back to the 1950s. To date, the method and theory of HFE, including its principles and methodology, has played an important part in patient safety activities, and has gained more and more attention by the relevant health and hygienic institutions in developed countries, while its application in developing countries like China is still at the very initial stage with only a few research articles published, most of them theoretical rather than practical.

[The initiative of patient safety culture and its development].

Safety culture is the culture of all the connotations to a safe direction for the purpose of advancing a unified organizational behavior. Safety culture was first introduced to the field of medicine by the American researchers in the 1990s. Subsequently, researchers from different countries initiated the relevant studies and put forward five subcultures of patient safety culture. At present, the patient safety culture research is mainly conducted in the United States, China and the UK of which cross-sectional studies are the most popular study designs including the evaluation of patient safety scale, reliability and validity analysis. Non-sectional studies are focused on the study of subcultures including leadership, communication, cooperation and reports. Compared with the studies abroad, the studies on patient safety culture in China are rather late, yet also mainly on reliability and validity analysis of scales. Most participants we investigated are nurses from teaching hospitals. But in the real healthcare situation, fostering a positive safety culture is still very lacking and many ideas and behaviors are in the state of traditional blaming culture.

Hospital survey on patient safety culture in China.

BACKGROUND: Patient safety culture is an important measure in assessing the quality of health care. There is a growing recognition of the need to establish a culture of hospital focused on patient safety. This study explores the attitudes and perceptions of patient safety culture for health care workers in China by using a Hospital Survey on Patient Safety Culture (HSPSC) questionnaire and comparing it with the psychometric properties of an adapted translation of the HSPSC in Chinese hospitals with that of the US. METHOD: We used the modified HSPSC questionnaire to measure 10 dimensions of patient safety culture from 32 hospitals in 15 cities all across China. The questionnaire included 1160 Chinese health-care workers who consisted of predominately internal physicians and nurses. We used SPSS 17.0 and Microsoft Excel 2007 to conduct the statistical analysis on survey data including descriptive statistics and validity and reliability of survey. All data was input and checked by two investigators independently. RESULT: A total of 1500 questionnaires were distributed of which 1160 were responded validly (response rate 77%). The positive response rate for each item ranged from 36% to 89%. The positive response rate on 5 dimensions (Teamwork Within Units, Organization Learning-Continuous Improvement, Communication Openness, Non-punitive Response and Teamwork Across Units) was higher than that of AHRQ data (P < 0.05). There was a statistical difference on the perception of patient safety culture in groups of different work units, positions and qualification levels. The internal consistency of the total survey was comparatively satisfied (Cronbach's α = 0.84). CONCLUSION: The results show that amongst the health care workers surveyed in China there was a positive attitude towards the patient safety culture within their organizations. The differences between China and the US in patient safety culture suggests that cultural uniqueness should be taken into consideration whenever safety culture measurement tools are applied in different culture settings.

Effect of injection of brucea javanica oil emulsion plus chemoradiotherapy for lung cancer: a review of clinical evidence.

OBJECTIVE: Injection of brucea javanica oil emulsion (IBJOE), one of Chinese patent drugs has been widely used for lung cancer (LC) in China, and is known to provide some favorable outcomes, in particular when it combined with conventional treatment. However, little available best evidence is known about its effect and safety. This paper aims to evaluate the effectiveness and safety of IBJOE plus chemoradiotherapy to alleviate symptoms of LC patients. METHODS: A complete literature searching was conducted in databases including Chinese Biomedical Literature Database, China Academic Journals Full-text Database, Chinese Scientific Journals Database, the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE to identify randomized controlled trials (RCTs) of IBJOE with chemoradiotherapy versus chemoradiotherapy alone for LC patients regardless of blinding, duration of treatment or duration of follow-up. All searching dates were from the beginning to December 2011. Quality of the included studies was assessed using the method by Cochrane Reviewer Handbook, and data analysis was performed using RevMan 5.10 software developed by The Cochrane Collaboration. RESULTS: The searching yielded over 1371 relevant citations, most of which did not meet the inclusion criteria. Finally, only 21 RCTs involving 1619 patients were included, and all the studies were of poor quality. Pooled analyses were performed to reveal that compared with chemoradiotherapy alone, IBJOE plus chemoradiotherapy had a better complete response rate (relative risk (RR) = 1.42; 95% CI 1.05 to 1.92; P = 0.02) and improved quality of life (RR = 1.83; 95% CI 1.63 to 2.07; P < 0.00001) measured by Karnofsky Performance Status scale. In addition, there was a significant difference on the outcome of long-term survival rate, level of immune function, and some incidences of adverse effects. CONCLUSIONS: IBJOE plus chemoradiotherapy may have positive effects on LC patients in response rate, improvement of quality of life, and reducing incidences of some adverse effects compared with chemoradiotherapy alone. However, the results need to be viewed with caution because of low quality of the included studies.